Troubles Sleeping ?

 

Many of us think that as we age, we need less sleep in order to function well during our waking hours, possibly due to the perceived lack of activity of older folks as compared to the young who run, jump, and play all day long. There is no general consensus among sleep professionals on this subject. It is clear that kids do seem to require more sleep in order to maintain such an active lifestyle. However, one thing is certain, we all need a solid night’s sleep in order to keep running at optimal speed during the day. For many older folks, that is just not happening.

 

Why? Well, as we age, our lifestyles change, which can and does create potential sleep disturbing issues. For example, we take on more responsibilities, which can develop into worrisome thought, which then can lead to sleep interruption. So as we get older there are many “issues” that can develop, thus adding to sleep disorders. However, there are other more specific reasons for these sleep disorders. Sleep apnea is a major cause of sleep disruption. Apneas are basically an absence of airflow for 10 seconds or longer during our sleep period. When multiple sleep apneas occur during a sleep period, restful sleep is clearly interrupted and the solid night’s sleep is lost.

 

There are also sleep related movement disorders, such as restless leg syndrome which is the need to move one’s legs as a result of “uncomfortable” urges. There is also the more prevalent movement disorder, periodic limp movement disorder, where one’s limbs (again, usually the legs) jerk every 20-40 seconds during sleep periods. Both of these sleep related movement disorders can easily be disruptive to sleep.

 

REM behavior disorder is a disruption of our normal dream process. In this disorder, the elder (and often in men beginning at age 60) experiences incomplete REM cycles, or a temporary paralysis (low muscle tone during REM), that prevents the dream from being enacted, and can often manifest itself in more violent dreams forms. Often, this form of sleep disorder is a precursor to another form of illness, such as dementia or Parkinson’s.

 

The result of these different sleep disorders can be correlated to many of the elder’s symptoms: lack of full night’s sleep, waking up often during the night, difficulty falling asleep, and increased confusion. Often, an elder will seem more depressed, have associated memory issues, will begin napping more during the day and/or begin using more over-the-counter sleep medications as the effects of their sleep disorder(s) continue. It is important to recognize these symptoms in order to treat the underlying disorder.

There are several easy thoughts that are readily at hand:

 

•       Develop a healthier lifestyle (eat better, exercise regularly, etc.)
•       Avoid eating too close to bedtime.
•       Develop a bedtime routine and stick with it.
•      Use the bed for sleep and intimacy, not for watching TV, etc.
•       Don’t use caffeine prior to bedtime.
•       Put your worries to bed before you put yourself to bed.
•       Avoid daytime napping.
•       Keep the bedroom dark, quiet, and cool during sleep periods.

How do we get help ?

I get this question all the time, or at least some variation of it.  Mom has had a fall and needs….. Dad’s apartment isn’t getting cleaned…..How do we get someone to help my parents with their bathing…..etc. etc. etc.

Lets face it, until your parents need help do these things you are not going to go and find out what is available for them in terms of personal care, housekeeping, laundry, companionship or meal preparation.  Why would you ?  Quite simply you wouldn’t.  But once something happens or even once things are slipping to the point where you feel comfortable stepping in, then the questions come out.

First things first, your parents were the ones who raised you and provided for you when you were growing up (for most of us at least), they are the ones you turned to for advise as you were growing up as well as when you were raising your own family.  That in itself makes it very difficult to start a conversation that reverses the roles.  You are now helping them, and they are relying on you.  Talk about awkward !The only thing I can say is to get over it and get on with it.   Your parents need your help but unlike when you were a child, they are very able to participate in the decision making process, and their voices have to be heard and addressed.  You can’t force a solution on them, it doesn’t work that way.  Roles may have been reversed, but the veto power is still out there.

The next big step is get a commitment from your parents to take a honest look at the things that are not being coped with as well as they should be, and to accept the possibility of getting someone to look after those things.  Based on their needs, try to find one organization that will have the same person do the work each week.  A revolving door of workers is hard on Seniors.

Nickel For Your Thoughts…

Yes I know – the saying is “A Penny for your thoughts” but since the Canadian Government did away with the Penny, I thought I’d update the saying too.  My other favourite expression is “hope for the best but expect the worst.”

Speaking of keeping things up to date and expecting the worst things to happen, are your affairs up to date? It sounds like a simple matter but really it is a lot more complex than you might think.

Wills and Power of Attorney:  As life goes by, situations change, people come and go and our wishes change too.  If you wrote your will when you were in your 30’s you might have had a parent as an executor or guardian to your children.  Fast forward 20 years and Dad might have passed away and the kids grown.  Maybe it’s time to review things…..

Bank Accounts: If a person is unable to access their bank account, either due to illness (mental or physical) or death, who is going to pay any outstanding bills?  Hopefully there is enough money there, it’s just that nobody can access it till things get resolved.  Joint accounts avoid this issue.

Living with Illness:  Every year older means that there is a greater chance that something will go wrong.  Have you thought about what would happen if something catastrophic happened to you?  A massive heart attack or stroke that leave you incapable of looking after yourself or your family?  Plan ahead to make sure that if everything falls apart in your life that your family has the help they need.

Funerals and funeral costs:  $10,000 doesn’t go all that far these days when it comes to a funeral.  Making the funeral arrangements isn’t a whole lot of fun either.  Funeral Directors are wonderful people when it comes to helping with making the arrangements as easy as possible, but there is a limit to the amount of comfort that they can provide you.  Plus they want to be paid, see the paragraph on Bank Accounts above.

Homecare: Almost every senior I’ve ever met would like to stay at home if at all possible. Regardless of where home is, if we can manage to help people stay there, then that’s great.  Housekeeping, Personal Care, companionship, meals and medication reminders to name just a few of the things we do (a shameless plug for my business!!)

Aging should be a time of leisurely choices, not stressful decisions.  Planning ahead can help make sure that we have leisurely choices to make and help avoid having to make the stressful decisions.  Ask for help if you need to just don’t ignore the future.  Lets all hope for the best but be prepared for the worst.

The Cookie as a Cure

Sure, we know that guns kill.  We know that Cancer can be terminal, and most of us have that have kids have heard the phrase ‘Stranger Danger’.  Sadly there are legions of people who still don’t recognize the inherent dangers associated with Frustration, Anger and Stress.

All three of these are things that each of us deals with on a daily basis.  They are also things that increase with time, and therefore as we age.  While they are on the rise, our ability to deal with them decreases over time.  As age Father Time takes a toll on us physically, mentally and emotionally, our frustration at not being able to cope with specific things as we have done so in years past turns into anger and quite naturally leads to increased stress levels.

The Frustration, Anger and Stress may be exhibited with anger and hostility, tears, depression or other changes in moods, or even a change in appetite and or alcohol consumption levels.  With Seniors less obvious or perhaps less recognizably associated signs include changes in physical and mental health.

 

Communications and education are very important in dealing with pretty much every life threatening issue.  If only we could talk Cancer into remission; if only we could sit and listen to a person with Parkinsons’ and erase the disease.  Good communications and proper education help us to deal with such diseases but with Frustration, Anger and Stress, communication and education not only help deal with the day – to – day issues, but sitting talking and actively listening actually are part of the cure.

By sharing the frustrations, the Senior is actually participating in his or her own cure.  Helping a family member, friend or neighbour with the things that cause their Frustration, Anger and Stress might help to reduce their blood pressure; it might help them to rediscover their appetite or ease the depression.  Any one of these outcomes could save their life.  For the moment at least.

Since Frustration, Anger and Stress are unavoidable each of us has a responsibility to follow up with what we’ve started.  It’s not enough to just passively sit and listen and then to assume that the problem is solved.  Implementing preventative measures can help, such as getting hand rails installed or a special phone with extra large numbers and that lights up when a call is coming in.  Regular and timely follow-up may be as simple as calling the house to chat every couple of days; taking in the garbage bins for the neighbour; dropping by with a couple of warm cookies that you made.

Who knew that a cookie could be the start of a cure !!!

Drivers Licenses & the Family Car

Have you ever bought that car that was only driven by the little old lady who just drove it to church ?  I have.  Actually, it was just to the grocery store.  At some point regardless of whether or not our parents have been able to renew their drivers licenses, we might need to have the conversation with them about no longer driving.

With the growing number  of older drivers and today’s driving complexities, there is increased concern amongst many people about the safety of our parents.  Deciding to give up ones driving license is very difficult for Seniors to make on their own.  Perhaps this article will provide you with some supports or ideas about the discussion that you decide to have that conversation.

Driving is not the same as it used to be.

The first thing that we, the adult children need to recognize is that driving is just as important to our parents as it is to us.  It is their link to the grocery store, to church, to many of their social activities, not to mention it is where ‘The Sunday Drive’ happens.  Our parents have had this routine for many many years and, just like everyone else, the family car has become a focal point.

Talking about giving up the family car can be very emotionally charged.  We have to make sure that we are being open, honest and persistent with our parents.  Get the support of their Doctor (assuming he/she agrees) and other family members or friends to show them that you are not the only person looking out for them.  Encouraging your parents to reduce the amount that they drive is a good start.

Make sure that everyone understands that when someone loses the privileged of driving, that they can start to feel lonely, anxious or depressed because they have less opportunities to be with their friends or less involved in certain activities.  But there are also other options, we can pick up the slack, other friends will help too – that’s what friends do if you ask.  Explore the options first.

Remember to be sensitive to the older person’s feelings, you can expect some emotional reactions.  It’s our job as the adult children to do whatever we can to help them through this trying time.

It is important to understand that even after taking steps to correct diminished eyesight or hearing, and after successfully avoiding adverse reactions to medication, an older person still may not feel comfortable behind the wheel.  Encourage the older person to discuss this with you, another family member, friend or doctor.  As a  family member or friend, you must be sensitive to this insecurity.

Good luck !

Warning Signs:

Mental reaction time is crucial to safe driving, as we age this slows down.

Failing Vision makes it harder and harder to drive properly.  Especially peripherally.

Horns, Sirens and whistles are high pitched sounds which are the sounds that tend to go first.

Planning Ahead

For most of us we started learning about money, banks and banking as a child with our first savings account.  Maybe with birthday money or money from the Tooth fairies.  Regardless of how it started, over the years it develops, changes and expands.  Chequing accounts, credit cards, mortgages and retirement savings accounts.  There are a few things however, that many people don’t learn about banks and banking until it is too late.  After so many years of helping the kids with money, the things we eventually need to know are a complete reversal because they usually involve helping our parents and their money.

The learning curve ideally begins before either of your parents passes away or becomes unable to manage their affairs on their own.  While this is a great idea, acting on it is usually not done, but once things start to change with our parents we need to be in a position where we can step up and return the favour by providing the help they need.

Below are a few simple things that can be done ahead of time to make sure that their money is not one of their issues.   Simple to do, but very difficult to get them done with your parent(s) – you’ll understand soon.  Together with your parent(s) you need to make 3 visits at least (in no specific order)

1) Bank.  Everyone knows that you can not take money out of just any account.  You have to have a right to the account, either you are named on the account or you have legal authority to access the account or it becomes yours through proof of inheritance (probate).  Once an account holder passes away, the Power of Attourney is no longer valid so how do you pay the outstanding bills without using your own money while you wait for probate?  The easiest answer is to plan ahead, by having your name added to the account ahead of time.  The understanding of course is that you won’t touch the account till both your parents are either gone or incapacitated.

2) Lawyer.  So no free legal advise on the blog.  Suffice to say that there are a number of things that you and your parent(s) need to ask about including (but not necessarily limited to just these.)

•  DNR order – Do Not Resuscitate
• Power of Attourney (personal care and financial)
• Living Will
• Will

Once the Lawyer has done their part, make sure that you and your parent(s) know where things are so that they can be easily and quickly accessed.  They should also be reviewed from time to time as situations and wishes change.

3) Final Arrangements.  Eventually we all die, and when the inevitable happens certain other things happen too.  Some of those things cost money and some can be handled ahead of time, and even paid for ahead of time. Those that remain to mourn can be eased greatly if the arrangements are prepared in advance.

Just discussing these things with your parent(s) is difficult.  Not only for you but even more so for them, mortality is a very difficult subject to discuss and always stirs up a lot of emotions.  Remembering this and respecting this throughout the process will help pave the way to a positive experience that can bring everyone closer.  If the Bank, the Lawyer, and the final arrangements are already in place, then when the day comes the burden can be lessened, and the mourning made easier.  Until then it is one less burden to carry.

The biggest thing to know is that you have to plan ahead and then to make sure that you know where things are and how to handle them when the time comes.

Homecare is not just at the House

According to legend (or history) over 1900 years ago a Roman by the name of Pliny the Elder is credited with the saying “Home is where the Heart is.”  Of course, we all know the saying and most people believe it to be true.  What I doubt Pliny the Elder ever thought about was that Homecare is also where the heart is. 

Just like a Housewife never married a house, Homecare is not about maintenance on the house, nor does it mean services are provided just in at the house.  Rather, the saying tells us that where-ever we are living is where our hearts reside.

Homecare is provided where-ever it is needed, and can certainly follow us anywhere that it is needed.  Regardless if whether a loved one is in a hospital temporarily or for a longer stay, Homecare can be there with them.  Homecare is regularly provided in Long-term care residences, Nursing Homes, hospices, retirement communities, condos and apartments.

Nobody wakes up in the morning and decides that they want Homecare for no reason at all, usually something prompts the decision. Where-ever we are living, and for however long we’ll be there we need to remember that Homecare is available where we call home.  Homecare is there to provide that extra level of service to help ease our burdens and to help make life a little nicer.

As the type of Home you live in changes, so too do your needs.  So too do the Homecare services.  If we are going to be moving into a Seniors Residence we may not need the same type of assistance that we needed before.  For instance the Residence may look after the laundry and the medications, but getting your home organized and dealing with the changes that are happening might be something can be helped with instead.  At the Hospital it might just be to fluff a pillow and to provide a friendly visitor through the day to help deal with anxiety, loneliness, depression or dementia.   Just knowing that someone is there can be such a tremendous benefit.

Home is where the Heart is, and so too is Homecare.