FRIENDS OF CAREGIVERS
By: Lisa M. Petsche

Friends of Caregivers Can Help
10 ideas for providing support

In approximately one-quarter of American households, care is provided to someone age 50-plus. In most cases, family members and friends provide all assistance.

These unpaid helpers enhance the quality of life for ill older people who might otherwise require placement in a long term care facility.

Typically, they are spouses or offspring, many seniors themselves.
The loved ones they care for have physical or mental impairment (perhaps both) caused by one or more chronic health conditions, stroke and dementia being most common.

The caregiving role involves physical, psychological, emotional and financial demands. It can also be one of life's most rewarding experiences.

The caregiving journey is often a long one, though, and particularly challenging when the elder has heavy hands-on needs, a demanding personality or mental impairment.

Burnout is common.

The following are some things that you, as a friend or relative, can do to help prevent a caregiver you know from wearing down.

1. Keep in touch. Accept that you may have to make most of the effort in maintaining the relationship. If you live at a distance or otherwise can't visit often, regularly call to see how the caregiver is doing. Send a card or note to brighten his/her day, and include a humorous anecdote or cartoon clipping.

2. Educate yourself about the care receiver's disease, to help you understand the kinds of challenges the caregiver might be faced with.

3. Listen non-judgmentally, demonstrate compassion and don't give unsolicited advice. Provide words of support and encouragement.

4. Offer to accompany the person to a caregiver support group meeting if concurrent care is available or they can make in-home respite arrangements; otherwise, offer to be the respite provider so they can attend a group.

5. Encourage the caregiver to practice self-care by eating nutritiously, exercising and getting sufficient rest in order to maintain good health. Do whatever you can to help make it possible. For example, bring over a meal or offer to sit with the care receiver while the caregiver exercises or takes a nap to catch up on lost sleep.

6. Ask, rather than guess, what kind of practical help you can provide. Perhaps it's dusting and vacuuming, doing laundry or running errands. If your assistance is declined, continue to express your desire to help. Meanwhile, take it upon yourself to deliver a casserole or muffins or, if you're a neighbor, sweep both walks or bring in both sets of garbage cans. Encourage the caregiver to ask for and accept help rather than go it alone.

7. Surprise the caregiver with a treat, such as a magazine, a rented movie, fresh flowers or a plant, gourmet coffee or tea, or a gift certificate to a favorite restaurant that has takeout and delivery service.

8. When it comes to special occasions, keep in mind that the most valuable gift you can give a caregiver is the gift of time. Offer to sit with the care receiver for an hour while the caregiver goes to a hair appointment or to a religious service, for example, or for a longer stretch so he or she can attend a social event.

9. If the caregiver is planning to host a party or dinner, offer to help with preparations or cleanup, or to attend to the care receiver during the event so the caregiver can concentrate on hosting duties and mingle with guests.

10. Offer to get information about community support services if none are in place, and encourage their use as appropriate.

ELDERSPEAK: Sweetly Belittling To Many....And Aging America: New Census Data

October 12, 2008

The first story below is about how we talk to seniors and the elderly - sometimes unknowlingly using terms of endearment such as "sweetie" or "dear", which may seem insulting or belittling to some elders, or talking about them in front of them as though they weren't there.

The article brought back two significant memories for me. The first was when my (admittedly bright, in my opinion) 3 year old son asked me one day, "Don't talk baby talk. Talk adult talk to me." To think, it bothered him to be treated, as he perceived it, as "less" at such a young age.

The second incident happened years later at the doctor's office when he was explaining to me, in front of my Mother, 71 at the time, how she should take her medications.

Suddenly, "I'M NOT DEAF, YOU KNOW", she said, "TALK TO ME", echoed off the walls on the exam room. Later, as we ate hot fudge sundaes, like we usually did after doctor appointments, she told me she felt bad about yelling, but said, while pushing her a cookie over to me, "It's hard enough being old, or being sick, but to be ignored is worse. What happened? When did I quit being an adult?"

It seems that we all are very sensitive to the treatment we get from others all our lives; children know just as adults do.

Have a great day
Gloria


In ‘Sweetie’ and ‘Dear,’ a Hurt for the Elderly

Photo: Heidi Schumann for The New York Times
By JOHN LELAND, New York Times 10-6-2008

Bea Howard, 77, of Berkeley, Calif., said she had been ignored by restaurant workers while dining with a younger friend.


Professionals call it elderspeak, the sweetly belittling form of address that has always rankled older people: the doctor who talks to their child rather than to them about their health; the store clerk who assumes that an older person does not know how to work a computer, or needs to be addressed slowly or in a loud voice. Then there are those who address any elderly person as “dear.”


“People think they’re being nice,” said Elvira Nagle, 83, of Dublin, Calif., “but when I hear it, it raises my hackles.


Now studies are finding that the insults can have health consequences, especially if people mutely accept the attitudes behind them, said Becca Levy, an associate professor of epidemiology and psychology at Yale University, who studies the health effects of such messages on elderly people.


“Those little insults can lead to more negative images of aging,” Dr. Levy said. “And those who have more negative images of aging have worse functional health over time, including lower rates of survival.”



In a long-term survey of 660 people over age 50 in a small Ohio town, published in 2002, Dr. Levy and her fellow researchers found that those who had positive perceptions of aging lived an average of 7.5 years longer, a bigger increase than that associated with exercising or not smoking. The findings held up even when the researchers controlled for differences in the participants’ health conditions.



In her forthcoming study, Dr. Levy found that older people exposed to negative images of aging, including words like “forgetful,” “feeble” and “shaky,” performed significantly worse on memory and balance tests; in previous experiments, they also showed higher levels of stress.



Despite such research, the worst offenders are often health care workers, said Kristine Williams, a nurse gerontologist and associate professor at the University of Kansas School of Nursing.


To study the effects of elderspeak on people with mild to moderate dementia, Dr. Williams and a team of researchers videotaped interactions in a nursing home between 20 residents and staff members.


They found that when nurses used phrases like “good girl” or “How are we feeling?” patients were more aggressive and less cooperative or receptive to care. If addressed as infants, some showed their irritation by grimacing, screaming or refusing to do what staff members asked of them.


The researchers, who will publish their findings in The American Journal of Alzheimer’s Disease and Other Dementias, concluded that elderspeak sent a message that the patient was incompetent and “begins a negative downward spiral for older persons, who react with decreased self-esteem, depression, withdrawal and the assumption of dependent behaviors.”


Dr. Williams said health care workers often thought that using words like “dear” or “sweetie” conveyed that they cared and made them easier to understand. “But they don’t realize the implications,” she said, “that it’s also giving messages to older adults that they’re incompetent.”


“The main task for a person with Alzheimer’s is to maintain a sense of self or personhood,” Dr. Williams said. “If you know you’re losing your cognitive abilities and trying to maintain your personhood, and someone talks to you like a baby, it’s upsetting to you.”


She added that patients who reacted aggressively against elderspeak might receive less care.


For people without cognitive problems, elderspeak can sometimes make them livid. When Sarah Plummer’s pharmacy changed her monthly prescription for cancer drugs from a vial to a contraption she could not open, she said, the pharmacist explained that the packaging was intended to help her remember her daily dose.


“I exploded,” Ms. Plummer wrote to a New York Times blog, The New Old Age, which asked readers about how they were treated in their daily life.



“Who says I don’t take my medicine as prescribed?” wrote Ms. Plummer, 61, who lives in Champaign, Ill. “I am alive right now because I take these pills! What am I supposed to do? Hold it with vice grips and cut it with a hack saw?’”


She added, “I believed my dignity and integrity were being assaulted.


Health care workers are often not trained to avoid elderspeak, said Vicki Rosebrook, the executive director of the Macklin Intergenerational Institute in Findlay, Ohio, a combined facility for elderly people and children that is part of a retirement community.


Dr. Rosebrook said that even in her facility, “we have 300 elders who are ‘sweetie’d’ here. Our kids talk to elders with more respect than some of our professional care providers.”



She said she considered elderspeak a form of bullying. “It’s talking down to them,” she said. “We do it to children so well. And it’s natural for the sandwich generation, since they address children that way.”


Not all older people object to being called sweetie or dear, and some, like Jan Rowell, 61, of West Linn, Ore., say they appreciate the underlying warmth. “We’re all reaching across the chasm,” Ms. Rowell said. “If someone calls us sweetie or honey, it’s not diminishing us; it’s just their way to connect, in a positive way.”


She added, “What would reinforce negative stereotypes is the idea that old people are filled with pet peeves, taking offense at innocent attempts to be friendly.”


But Ellen Kirschman, 68, a police psychologist in Northern California, said she objected to people calling her “young lady,” which she called “mocking and disingenuous.” She added: “As I get older, I don’t want to be recognized for my age. I want to be recognized for my accomplishments, for my wisdom.”


To avoid stereotyping, Ms. Kirschman said, she often sprinkles her conversation with profanities when she is among people who do not know her. “That makes them think, This is someone to be reckoned with,” she said. “A little sharpness seems to help.”


Bea Howard, 77, a retired teacher in Berkeley, Calif., said she objected less to the ways people addressed her than to their ignoring her altogether. At recent meals with a younger friend, Ms. Howard said, the restaurant’s staff spoke only to the friend.


“They ask my friend, ‘How are you; how are you feeling?’ just turning on the charm to my partner,” Ms. Howard said. “Then they ask for my order. I say: ‘I feel you’re ignoring me; I’m at this table, too.’ And they immediately deny it. They say, no, not at all. And they may not even know they’re doing it.”


Dr. Levy of Yale said that even among professionals, there appeared to be little movement to reduce elderspeak. Words like “dear,” she said, have a life of their own. “It’s harder to change,” Dr. Levy said, “because people spend so much of their lives observing it without having a stake in it, not realizing it’s belittling to call someone that.


In the meantime, people who are offended might do well to follow the advice of Warren Cassell of Portland, Ore., who said it irritated him when “teenage store clerks and about 95 percent of the rest of society” called him by his first name. “It’s the faux familiarity,” said Mr. Cassell, 78.


But he mostly shrugs it off, he said. “I’m irked by it, but I can’t think about it that much,” he said. “There are too many more important things to think about.”


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New Census Data: Aging America

By Sam Roberts
October 2, 2008,
From the Jane Gross Blog in N.Y. Times



Here’s a glimpse of the statistical future from my colleague Sam Roberts, who reports on census data, among many other things, for The Times. — Jane Gross


America is growing older. We knew that. But earlier this year, the U.S. Census Bureau quantified how much older and how fast it will happen. The numbers paint a picture of a nation on the brink of remarkable change.

Today, about 13 percent of Americans are over age 65. By 2030, more than 20 percent of Americans will be in that group. By 2050, about 89 million Americans will be over age 65, more than double the number today.

By 2025, the number of centenarians will more than double to 175,000, from fewer than 80,000 now.


By 2035, the number of people ages 85 and over will double to 11.5 million, from about 5 million now.

Still, the U.S. population overall will not be as elderly as these statistics might suggest. The nation continues to attract large numbers of immigrants, who tend not only to be younger but also to have higher birthrates.

As a result, the proportion of working-age people who are employed and pay taxes to support others, both younger and older, will be higher here than it has been in Europe and Japan, where proportions of working-age citizens have declined.


The disparity in death and birth rates, though, means older and younger Americans may not much resemble one another in the coming decades.

According to the Census Bureau’s latest projections, older Americans will more often be Caucasian than the rest of the population. (Black Americans are projected to have slightly lower life expectancies.) Deaths will outnumber births among whites beginning in the 2020s.

“In 2020, the burdens of seniors to the white working-aged population become larger than the burdens of children,” said Dr. William H. Frey, a demographer with the Brookings Institution.

But, he added, “immigrants and their children will contribute to labor force gains, which could very well have turned to the kinds of declines experienced by many European counties and Japan.”


Younger Americans will be a more diverse bunch than the seniors they are helping to support. By 2050, the Census Bureau says, the median age will be 44.6 for non-Hispanic whites, 43.4 for Asians, 38.9 for blacks, and just 31.2 for Hispanics.