Friday, November 1, 2013

Are Your Affairs In Order?

Do you feel like you are living each moment of your life to the fullest? Do you appreciate your loved ones and the blessings that surround you? Do you have all of your affairs in order? 

In January 2013 Valerie Harper was told she had terminal metastatic lung cancer. She remembers being terrified thinking she would not be here to see her daughter get married. But then she was able to focus on the practical matters - getting her affairs in order with her husband, Tony Cacciotti of 26 years. Her husband shied away from discussing the topic. His parents were born in Italy and he saw far too many people die, including his own brother, displayed in caskets in their living room. Because of those experiences, he doesn't go to funerals.
 
After some coaxing, Cacciotti agreed to see a lawyer to draft wills and health care directives. At that time, Valerie told her husband she wanted to be cremated - something he was not prepared to hear because he always thought they would be buried next to each other. According to Valerie, "The body is just a rooming house."  He never considered cremation for his wife.  Cacciotti explained his reluctance, "I wanted to be buried next to her." Over their marriage they did not discuss "what will we do when this happens?"   
 
Thankfully they had the opportunity to make plans, but Valerie and Tony waited until Valerie was diagnosed with cancer to make their plans. They didn't know what the other wanted because throughout their 26 year marriage, they didn't discuss the topic. Valerie didn't tell Tony she wanted to be cremated - pretty serious to be left until a person has such a serious medical condition. But she thought like many of us, she had a lifetime ahead of her. Her husband needed time to adjust to a plan that was so different than he had envisioned. He always thought Valerie would be buried next to him.

In regards to Valerie's attitude toward life, she feels people should 'live moment to moment to moment.' 'You should live in the joy of life, not worrying about the future.' She doesn't think about dying. 'I think about being here now.' Valerie has defied the odds. Doctors gave her three to six months and it is already November. Valerie looks at it this way - every day she is optimistic that she can have one more holiday, maybe two or three! "Happy Thanksgiving, Merry Christmas and Happy New Year Valerie!"

Have you considered long term care insurance? You may want to discuss it with your customer service rep at your bank or financial advisor. With this protection, most alternative housing and care is partially covered. Since costs and reputation vary significantly, investigate completely before deciding on a company. Research the companies you are interested in doing business. Some will not accept a person with a pre-existing condition such as heart disease or a combination of another medical condition like - seizure disorder, lupus, or obesity. If they do accept you, they may charge a very steep premium. Not all companies and policies are created equally.      

Have you examined your life? If the doctor told you tomorrow you had two months to live, would you have everything taken care of for yourself and your family? Would you wait for a crisis situation? Decisions should be made when you can make them with a clear mind and rationally. If you are married or have a partner, and both intend to set up a plan, discuss and write down all the things you want to discuss prior to the meeting so there are no misunderstandings later or in the lawyer's office. 

Consider searching out an Elder Law Attorney within your area to set up your plan -

The following should be included with your Estate Planning -
General Durable Power of Attorney
Durable Power for Health 
Living Will
Last Will and Testament

To find an Elder Law Attorney check out:- Find a Elder Law Lawyer - National Elder Law Attorneys - www.naela.org. Before you make your appointment, make sure you find out the general cost for his services. Consider calling a couple to compare services and costs. Once you meet with your lawyer, make sure you are comfortable with him. After he completes your Estate Planning, be satisfied with the plan. In general, review your Estate Planning every couple years in case there are any changes or revisions. A follow-up appointment with your lawyer is advisable so he can review your planning for any possible changes and/or updates. 

Estate Planning is something some may not want to face because we think it means the end of life. Look at it as protecting our loved ones and making life easier for them when we pass on. Often times, we do Estate Planning for the people in our lives who we care about. For example Tom may have a cottage he purchased prior to his marriage and he never put his wife, Kelly Ann's name on the Deed. If Tom doesn't have a will, or quit claim deed, Kelly Ann may not inherit the cottage if he has a sudden heart attack and dies. Even though the two were married for 19 years, the cottage could end up going to Tom's estranged, son Barry who he has not seen in 8 years. This situation could be avoided if Tom set up Estate Planning. 

If you do not have the funds to cover the cost for an Elder Law Attorney and decide you want to do your own planning, you can purchase  forms on the Internet - Power of Attorney, Durable Power of Attorney for Health, Living Willing, Last Will and Testament.

Embrace life with passion. But while you are doing it, think about your planning. What do you have in place when the time comes if you become ill and when you pass away?
    

Valerie Harper

Valerie Harper Tony Cacciotti


October/November 2013 AARP Magazine 
A Fearless, Funny Finale - Valerie Harper by Meg Grant
aarp.org/magazine

March 6, 2013 - Michael Rothman
Valerie Harper Diagnosed With Terminal Brain Cancer - ABC News
abcnew.go.com/blogs/entertainment

Monday, October 28, 2013

Watching Over Our Loved Ones

Consider how you would feel if you entrusted a long term facility to care for your loved one. Over the past four years, your loved one lived with you. But her medical condition declined and she fell several times resulting in calls to 911 for assistance. Despite your mixed feelings, her doctor told you your mother needed 24 hour care. After spending several weeks searching for a new home, you are quite sure Rolling River is the right match. 

Rolling River was clean and the staff helpful when you took your tour. They had a good ratio resident to staff and lunch was good. When you walked down the hall, the admission director knew the residents names. The costs was within the same range as other places you visited but this facility had a 5 star rating by the state and the rooms were larger. After review of all information, you believed Rolling River was the best choice.    

For several weeks, your parent had difficulty adjusting to her new "home". You received calls at midnight a couple times a week because she was crying and wanted you to visit her. Finally by the fourth week, Sandy, the rec director, convinced her to play Bingo, attend movies, and eat meals in the dining room. Your parent was more content. She was meeting people and enjoying herself.

You are finally taking deeper breathes and relaxing - hasn't happened in a long time. Then you get a phone call from Pauline, Social Worker, and you have a feeling it isn't good news.  
"Joanna, this is Pauline Scott, from Rolling River calling for your mother, Hilda Mayfield. Not an emergency. Your mother is upset but otherwise okay."
"What happened?"
"We recently hired a CENA's and she was caught stealing from several residents. A nurse found the CENA in your mother's room. Caught in her purse taking out money and a charge card, then stuffing them in her pocket. When the nurse checked both pockets, the nurse found your mother's watch, two bracelets, and two necklaces. The police are here now investigating."
Joanna told Pauline, "I'll be right over."

Joanna rushed to the care facility to help see her mother. For four years, she kept her mother in a safe environment. Within a couple months of having Joanna's mother in a care facility, her mother was a victim of a robbery. Pauline apologized to both Joanna and her mother numerous times. She  explained in the 20 years she worked at Rolling River, this is the first incident of stealing by an employee.

"That was a very brave nurse who caught her. She even called 911 while she was in the room with the woman and Hilda. The CENA cooperated and no one was hurt. Think she was embarrassed. Do you how much money your mother had?"
"Look inside the zippered lining. I kept her money in a envelope with the dollar amount. Whenever she spent money, I deducted that amount. I asked her not to spend money unless I was present. She had $57. I didn't want her having the checkbook, charge and money but she insisted. Told me it helped her feel independent. Now look what happened." 

"Remember when the Admission Director, Elizabeth, told you and your mother about leaving valuables in the rooms? We prided ourselves on never having a robbery, but  we are also realistic. If a resident doesn't have things of value, it cuts down the chances he will be a victim of this type of elder abuse. We care about our residents and do not want anything  happening to them. Perhaps now you will be able to convince your mother to let you take the checkbook and charge home and leave a small amount of money. Bring her a change of jewelry once or twice a week."

"I do remember Elizabeth telling Mother and me about valuables. But then she put up such a fuss when she moved in it was my way of calming the waters. I thought once she settled in, I could convince her to give them to me. But she wouldn't give them up. I should have had Elizabeth come in for a talk. Was getting frustrated, gave in. Should have been stronger. Then it wouldn't happened."

"Don't blame yourself for the actions of this employee. She stole from your mother and other people. Our other social worker, Ken, may be able to help your mother work through this incident. We do not want her to feel like a victim. She trusted her CENA."
"Thanks. I'll come by your office in a couple days for a status update. I'm going to see my mother. Want the nurse to help Mom into bed. She could use rest."
"Sounds like a good idea. She's been through an ordeal today."

Hopefully, you or your loved one will never have  to endure an experience of robbery. Be proactive. If your loved one resides in a care facility, make sure there is nothing of value in his room. If he insists on keeping his checkbook and charge cards, then set up a meeting with the admission director. 

Stealing is a form of abuse to seniors that sometimes does not get reported because the elderly person, trusts the person who steals from them. Sometimes it is a friend, caregiver, or their child. They might trust them with their charge card, check book, or cash. Then these people victimize trusting elderly seniors. As caregivers we cannot always protect our parents but we can have talks with them about elderly financial abuse. Whether your loved one insists on keeping her checkbook, and charge card, or passes them on to you, have an online account so you can monitor them every few days. You cannot stop abuse from happening but preventative measures is a step in the right direction.                     




Hilda and Joanna 


































Thursday, August 1, 2013

Caregivers - Take Care of Yourself

 
 
A Prayer for the Caregiver
By Bruce McIntrye
 
Unknown and often unnoticed, you are a hero nonetheless,
For your love, sacrificial, is God at his best,
You walk by faith in the darkness of the great unknown,
And your courage, even in weakness, gives life to your beloved.
 
You are resilient, amazing, and beauty unexcelled,
You are the caregiver and you have done well!
 
Caregivers, you deserve recognition for your tremendous contribution to families and society. You are the silent heroes and heroines. In order to give the best care possible to your loved one, you must take care of your needs. So often, caregivers take a backseat to the wants of the care recipient - this may work for a short term but not for the long run.
Learn to be proactive. Caregiving is a delicate balancing act so you need to continuously be prepared. What are some practical methods?
- Use a 'Sphere of Influence' - You care for your parent, friend, or spouse, from a sphere of influence. The people who influence your loved one may be you, your sister, Angela, and her husband, Peter, and their doctor, Michael Wildwood, D.O. Then you have influence from others such as your husband Christopher, your daughter, Juliana, and son, Auri, your family internist, Marshal Nordstrom, M.D. and your mom's best friend, Lily. As you care for your love one, you gain knowledge from others and the sphere continues. And think about all the people who gain information from you and all the people we mention in this group. Consider using your 'sphere of influence' by tapping into resources around you and passing them on.
- Want to relieve tension? Sit in a rocking chair and rock away your troubles. People hold babies rocking them in their arms to console or help them fall asleep. My grandmother spent countless afternoons relaxing in her rocking chair.
- Exercise lifts your spirits and energy. Start off slow and increase gradually moving to an amount of time that is comfortable. However, consider meeting with your doctor for an evaluation prior to starting an exercise routine.
- Open up the blinds in the morning and switch on the lights. Light helps us feel more alert than dark.
- Eat healthy breakfasts high in fiber, fruits, and vegetables. Avoid fat-free because some people crave more food after eating rather than choosing low-fat. Stay away from fast food. If you do go, check calorie content prior to ordering.  
- Comfort foods may taste good - they decrease stamina.
- Respite is not a gift. Learn to ask others for help. If you do not have anyone, develop a plan. Even if you find someone for two hours every other week, that is a start.
- Stay connected by calling friends and family on a consistent basis.   
- Other caregivers understand. They live what you are going through. Join a support group - whether it is one in your community, online or both.
- If you start feeling depressed, seek out professional help. 
- Some places of worship have programs and also people you can talk with. With many, you do not need to be a member to participate.
- Maintain physical health with medical and dental appointments. Take medications and supplements as recommended by your health care provided.
- Contact Area Agency on Aging - learn about services in your community. Look for local resources for caregivers.
- Consider Adult Day Care Centers and In-Home Caregivers.  
- Take warm baths. Or go in a room, close the door and read or listen to music for 20-30 minutes.  
- Find something that brings you peace whether it is mediation, spirituality, faith, or all of these.
- Tears are cleansing. Give yourself permission.
- Appreciate your efforts and do not hold on to guilt.
- Maintain a sense of humor.  
 
I would like to say I do all these things because I don't. Caregiving is not easy. It is a constant check and balance. I usually know when I need to work on an areas. And I know if I am having difficulty then there is an underlying reason. Being aware and not giving up is key to taking care of yourself.  
 
Caregivers - Each day do something especially for you. "Reach for Your Special Rainbow" - whatever that gift may be and cherish it.  
 
             


Friday, July 5, 2013

Accommodating the Accommodations



ACCOMMODATE - TO PROVIDE FOR, ADAPT, ADJUST, MAKE AN ADJUSTMENT

If someone mentions accommodations for our loved ones, we might think along the lines of bathroom modifications or wheelchair ramps. However, an accommodation does not necessarily need to be complicated. Your loved one was having difficulty walking over several months. When you made an appointment with her internist, he referred you to an orthopedic specialist. After an examine and an MRI, the doctor determined your mother's lower back had severe arthritis. To accommodate or make and adjustment for your mother, the doctor prescribed a walker with wheels to take the stress off your mother's back and legs along with mediation to help control the pain. 

Have you ever thought of all the times you have tried to figure out how you were going to accommodate your loved one? And every time you thought "It's not going to work." It does. You don't know how you will ever manage to get your dad to go with you for Sunday dinner. He doesn't like to go and usually comes up with an excuse to cancel. This time you thought fast. You brought along your daughter, Lucinda, to pick him up. When he saw his grandbaby, your dad had a huge smile along with tears streaming down his face. Then she went up to him with a hug and held his hand. He couldn't resist his granddaughter. Your little girl was the accommodation you provided for your dad to lift his spirits. After you thought about it, you realized your dad needed more accommodations or adjustments like Lucinda to brighten his life. You want your father over for dinner on Sundays and realized he stopped going to church when he stopped driving. Your wife and kids all overwhelmingly supported the idea of taking your dad to church and then having him for the afternoon. This adjustment changed your father's life. He had something very special to look forward to every week.      

                                                              Pop and Lucinda


When my mother goes out, she goes with my husband, Jack and me, in my Escape. She likes the car because she is able to get in and out of it. She uses a wheelchair, and she is able to stand just to transfer to get in the car, on the edge of the seat and then push herself all the way up. I had a Taurus X and when I traded it in, I had to purchase another car with seating height similar to accommodate my mother. I told my sales rep, Brent, who I have been working with for about 15 years, that we needed to find a vehicle that my mom would be able to get in. We went through all the cars and checked them until be decided on my silver Escape. Every time we pick up my mom, she tells me what a pretty color and how comfortable the car is for her. So taking the time and having a patient sales rep., like Brent, I was able to find a vehicle, to adjust to my mother's situation.

Elena worked as a legal assistant for twenty years until she was diagnosed with MS. She had to take a medical retirement because of the severity of her condition. Her husband, Peter, worked as an electrical engineer, and averaged ten hour work days. That meant there were evenings Elena did not see Peter because she was already in bed. Finally Elena asked Peter to make some adjustments to his schedule. They figured out what days he could leave earlier and finish his work at home. He talked to his manager about leaving work at 4:30 instead of 7:00 three days a week with the agreement he would finish any assignments at home. This accommodation with their schedule worked. Peter and Elena were able to go out for dinners and spend time together.

As caregivers, we are continuously thinking of creative ways for making accommodations. You can go the traditional route of reading an accommodation book but you may be overwhelmed by chapter two. Instead watch, talk with, listen to, and learn all you can from - other caregivers, employees working for home health agencies, individuals in the medical and mental health field, people in the rehab field, and your loved one. Research information about accommodations on the internet. Check out the accommodation website - JAN. Share your ideas with others. Then when you take out your accommodation books, you will have a better understanding. The books give us wonderful examples and information especially if you are doing a modification. But it's fun to come up with 'out of the box' accommodations and share them with others. That's how we all learn.













Thursday, May 30, 2013

Mickey's Anniversary

Dear Mickey -
No matter how many years pass, missing you will never change. You were my buddy. I loved hanging out with you and Mom. I treasured our lunches at your house. I came a little early and we talked while you prepared lunch for Mom and me. Then when Mom came home from her job at the elementary school it was all ready and we ate and talk. I spent many happy times with you and Mom. Out of the many days we spent as a 'team', one of my favorite was in February 1991. You and Mom came with me to help select my wedding dress. We went to several places. As soon as I tried on one dress, you both looked at each and we knew that was the dress and I picked it for my wedding. Not too many brides invite their fathers along when they shop for their wedding dress. Having this experience with both of you was one of the most memorable ones I have.
I didn't want you to suffer from your cancer any longer but it was so difficult letting you go. When you told Mom "Peace, Peace", you knew it was time. And I knew also. June 6th is the 8th year of your passing. Despite the years, I continue to miss you. Mom and I talk about you a lot. But then you probably already know that. Mom told me she likes to talk to your sailor picture. Then she looks at your wedding picture and says she doesn't know why you have the white sailor hat on instead of the navy one. Why didn't the two of you have such an important discussion prior to you leaving us?
Daddy - I will love you forever and ever and ever - Ce

I was my father's significant caregiver while my mother was his primary. He was diagnosed with Multiple Myeloma in May 2004 and passed on within one year. Despite his pain, my dad somehow managed to maintain a good disposition and staff appreciated his upbeat attitude. He went from rehab to hospital back to rehab until he finally spent his last days in University of Michigan - Ann Arbor where he left this world for the next. We don't want to see our loved one suffer but it is sure tough to part from them. And when people tell you that it gets easier over time. Then they never  met my dad. For that matter - they didn't meet either of my parents. I have terrific parents and boy could they dance! Jo and Mickey glided across the floor like Fred Astaire and Ginger Rogers. I acquired my love of dancing from them. I started calling my parents Mickey and Jo as a joke many years ago and sometimes think I say it more than Mom and Dad.


At times I can carry on wonderful conversations about my dad yet other times I become extremely emotional. My dad was 5'7". But to me, he was a giant - a loving, caring, humorous, sensible, incredible giant!   




  
Jo and Mickey 
Mickey and Cecelia

Wednesday, May 8, 2013

Caregiving Two Very Special People in My World - My Parents

"A Tribute to Two Very Special People in My Life"

In 2004 I the made the decision to embark on a project that changed my life. My father was diagnosed with Multiple Myeloma in May that year. After the shock of hearing this news, my life has never been the same. The man who could walk faster than me in any store suddenly spent the rest of his life between hospitals and rehabs facilities. I became my father's significant caregiver and my mother was his primary. All three of us were traveling through virgin territory. We were not only dealing with our personal anger, confusion, depression, and frustration, we were also going through all the procedures with doctors, hospitals, rehab facilities, and billing departments. At times, we became overwhelmed with everything we needed to process.

Because of all the issues we were experiencing, I decided to create a caregiver manual. I wrote a few pages of the Prologue and brought them to my parents for their input. I also wanted permission because I planned to use examples out of their lives. After I read a few pages, my dad responded immediately. "Of course, honey. That would be great!" At first my mother hesitated but once I started she became a strong advocate. Through the inspiration and guidance of my parents Michael and Josephine Salamone, I created a practical, easy-to-follow manual - Designated Caregiver - Resource Manual For The Caregiver "On Call 24/7".

As a result of my research and personal connection with Christine Goldberg, the facilitator from Adult Wellbeing, I emphasized to my readers the importance of becoming involved with caregiver support groups. They are instrumental in helping caregivers maintain emotional balance in additional to gaining a wealth of knowledge from the facilitator and members. With our Canton group, when someone discusses a situation, people offer suggestions and encouragement. This group has thrived because they care and work as a team.

My father passed in June 2005 and within six months my mother fell and fractured her left femur. She needed emergency surgery. Then in September 2006, she required another surgery for the same leg followed by two more surgeries in 2011. Since 2006, my mother has been in the hospital and rehabs approximately eight or nine times. Within six months of my father's passing, I became my mother's caregiver. My parents cared for me growing up; and it has been an honor to give back just a small amount of what they did for me.

As a caregiver, my biggest challenge has been to help maintain my parent's emotional wellbeing and keep them laughing. The ability to laugh is a gift from God that helps look at life in a positive, much brighter perspective. I grew up in a home filled with laughter but living with the unknown regarding my parent's medical conditions definitely test my strength. If I Dad was down, I would think of ways to cheer him up. Mom and I spent many 'ten hour days' at the hospital with my father. By that time all of us were exhausted so I would tell Dad, "Okay Mickey, I've been on OT for a couple of hours." He would say, "Well honey, you  better go the nurse's desk and fill out an over time form." Then we would both laugh.

I was extremely close to my father and do not know if I will ever fully get over his passing. Fortunately, I have many happy memories.

Not only has my mother had to cope with the complications from her medical conditions, she also misses my father--he was her life partner for 60 years. Some days she feels down because she looks at his picture and remembers their life together. I will think of one of Dad's humorous antidotes or something Mom and Dad did together to get her laughing. I started calling my parents Jo and Mickey when I was in my 20's and then it got to point I called them Mickey and Jo more than Mom and Dad. I can usually get a smile from them with "Hey Jo, (or Mickey) what's going on?" When I jump around along with my greeting, adds additional effect. Saying "Hi Mom (or Dad) how are you?" just not the same.

Last week I greeted my Mom but she was sad that day. It took me about three hours to get her out of her depression. I told her a few funny stories, turned on the Ellen show, and recruited a couple of the aides who I know brighten up my mother's life. We all got my mom laughing and joking around. I was able to breathe easier because she was in good spirits when I left.

According to Douglas Smith, American's leading hospice expert, young children laugh 400 times each day while adults barely manage 15 chuckles! Laughter is strong medicine for the mind and body, and good for a person's health. And it also has been a wonderful way for me to care for my parents. However, laughter is only one of the many ways I have cared for them. They have all contributed to my parent's well being.
PEOPLE WHO LAUGH, HELP BRING
JOY AND WELL BEING TO THE WORLD !!!
 
This tribute is in the present tense even though my father has passed. However, he will always live in the present for me.