Caregiver Issues

When Elder Care Hurts: Caring for Elders who have been Abusive or Neglectful

I was working as a consultant and referral resource for family caregivers when I received one of my most memorable calls.  On the other end of the line was a mid-level manager for a large corporation, and I could hear panic in his voice as he rushed to tell me his dilemma.

“I got a call from a hospital in Atlanta,” he said.  “They’re telling me my father is there with a broken hip, and they told me to come and get him.”

He paused and took a deep breath.

“That man was an abusive drunk,” he continued.  “He abandoned me and my whole family when I was only fourteen.”

His voice cracked and trembled as he struggled to keep his composure.

https://www.flickr.com/photos/jakojellema/2600417364/in/photolist-4XMPu9-8vHch7-4V94UT-6rvoPR-6o2frb-jAtQoz-299P43-jgEHMx-7bcpB-2AtH5a-dM6Pkg-4pnsEs-5Dbriu-HXBsc-4avuHw-9bPRi2-5NSCsY-4dBXDt-97Yr6R-5aKkTC-6iKKDV-3CC55L-fbX9hM-7WytjZ-bqgxXB-8v549b-8KuSE1-7k84rq-6S9Fr9-fDPh-3gu1gQ-askTBA-9VHCfx-eJ7cdg-5vSxGV-dK6d2K-3uPbLA-5mK84Z-bbo868-akGb3H-9ZN2VU-7jRdMy-bAnW81-bpMNd9-Ej3H-iUbpPt-5q6ZCp-4Q7YHh-98NC6U-hxicML/

“Sad” by Jako Jellema

“I went to college, got a good job, and I’ve raised a nice family.  I was determined to do everything that he didn’t do, and I’ve been successful.  Now I feel like I’m fourteen again!”

He wept openly on the phone, gripped by all of his childhood feelings of hurt, loss, and shame.

My heart broke for the boy who had worked so hard to become a man, for the man who was desperately trying to reconcile the demands of the moment and the terror that had seized him from the past.

We talked for a bit, and I realized that he needed permission to say “no” to the hospital’s discharge plan.  He needed reassurance that there were services available to care for his father, and that it was OK for him to set this boundary.  He needed support to deal with the difficult choice he was making.

The hospital didn’t know the situation, and the default discharge plan was to send their patient to his only son, even though they were separated by decades and distance, and by hurtful deeds that had been plastered over with diplomas and certificates and mortgages, but never really healed.

That day, I learned in a visceral way that many people provide care to older relatives, not because they want to or because they can, but because they feel they have to, no matter what.

  • Some children of abusive or neglectful parents simply opt out of providing care when the time comes, and while no one came blame them, they are often criticized by other family members for “not helping.”
  • Others engage in caregiving in a last-ditch attempt to gain approval and gratitude from a parent who has never been able to give it.
  • Still others provide care because it fits with their personal values and sense of morality.  They may say, “I would never treat another human being the way my Mother treated me.”

We know the stresses of caring for an older loved one can negatively affect one’s physical and emotional health.  Now we’re seeing research on how caring for a family member who has been abusive or neglectful can add even more risk for family care partners.

If an adult survivor of childhood abuse chooses to engage with a parent who has been (and still may be) abusive, they are likely to confront the ways that their family of origin has affected them.

Recent brain science shows us that children who are abused or neglected are changed by the experience and may be predisposed to chronic illness, obesity, anxiety, depression, and addiction.  There are social consequences to early deprivation, too, including lower academic achievement and socio-economic status.

The good news is that some relatively simple approaches can reverse those damaging effects and improve quality of life, and help survivors cope with caregiving if that is what they want to do.

It’s critical for these caregivers to connect with emotional support for themselves, and to obtain adequate help with caregiving.

With proper support and the development of a care partner team, there are possibilities for family and individual healing that can cascade through generations previously wounded by abuse and neglect.

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Do you know of situations where someone provides care for an Elder who has been abusive or neglectful?  Please share your ideas about what helps them cope in the comments section below.

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Lisa Kendall is a clinical social worker and gerontologist with a private practice in Ithaca, NY.  She has a passion for supporting Elders and their care partners, and offers trauma-informed treatment to adult survivors of childhood abuse and neglect.

Rest and Renewal for Caregivers, in Only 10 Minutes!

In 2011, I wrote a blog post about the importance of regularly taking time away from caregiving, often referred to as “respite.”

 

At that time, I suggested that in every day, we should have a respite of at least 10 minutes or so, and in every week we should plan for an hour away, if at all possible.

 

Increasing stretches of time call for more time away… in a perfect world!

 

In the years since that post, I’ve had the privilege of presenting workshops about how to structure a mini-retreat, and I’ve continued to talk with care partners about how this method of respite works for them.

 

I’ve also learned from the latest brain science that even very small breaks, when given our full attention, can have a significant positive impact on our health and well-being!

http://www.flickr.com/photos/alicepopkorn/3059251051/

by AlicePopkorn via Flickr

 

Jennifer Louden’s “Woman’s Retreat Book: A Guide to Restoring, Rediscovering and Reawakening Your True Self –In a Moment, An Hour, Or a Weekend,” helps us think about what we hope to get from our retreat, and how to create one that will really work.

 

She reminds us that you don’t have to have a lot of time or money, nor do you have to actually leave town (or even the house) for a break to refresh and renew your mind, body, and spirit.

 

This is good news for care partners!

 

The basic elements for a retreat include the opening, the retreat itself, and the closing.

 

The opening of the retreat includes an act or ritual to indicate that you are stepping away from your usual day, and entering into a sacred or special space.

 

It might include a prayer or other reading, getting up from your desk, going to a corner of your home suitable for quiet contemplation, or ringing a bell.

 

Once inside this retreat space, which Ms. Louden calls the retreat container, you engage in an activity you’ve planned, and which fulfills or contributes to your intention for the retreat.  If you’re feeling stressed, you’ll want to connect with a feeling of relaxation.  If you’re tired, you may want to do something that will energize you!

 

This could be a few moments of silence, mindfully listening to your breath.  It could be taking out your journal to write some lines about how you’re feeling and what you’re thinking, at that very moment. If you like to draw, your retreat space could hold some art supplies for you to play with.

 

Perhaps 10 minutes of wild dancing will provide an energy (or attitude) adjustment.  I used to do this with my daughters at the end of the school day, and we found it vented all sorts of cranky energy, and made us laugh.  Really hard.

 

Ideally, a retreat will connect with all of the senses, so consider doing something for the body (breathe, stretch, or handle a cool, smooth stone); for the sense of smell (fresh flowers, cinnamon, eucalyptus, a vanilla or pine scented candle); your sense of hearing (the gentle tinkling of a bell, music, or silence); and vision (have something pleasant to look at).

 

The closing is often a mirror or reversal of the opening ceremony.

 

If you started with a bell, end the same way.  If you lit a candle, blow it out.  You are signaling the end of this special time, even when it’s only been ten minutes, and a return to routine.

 

These simple steps bring our awareness to a mental and physical space where we can renew our energies, manage stress, and keep fit for the Elder care journey.

 

Jennifer Louden’s book is a true treasure trove of ideas, providing important information on how to prepare for a retreat of any length, how to create emotional and physical containers for your experience, and consider what to do (and not do!) on your retreat.

 

You’ll want to have your own copy of this book; you can purchase it now on the Crossroads Counseling Bookstore by clicking HERE.

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How do you rest and renew yourself?  What works best for you?

What will you try today?

Leave your comments and share your experience with others!

 

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Lisa Kendall is a geriatric social worker with a private counseling and consulting practice.  She teaches, trains, and facilitates a variety of different retreats. 

Are You Happy to Break the Good Dishes? (or… “Eat the Cherry First!”)

 

I recently splurged on a set of adorable Moroccan tea glasses, something to remind me of my favorite Philadelphia restaurant and the great meals I’ve shared there with my Sweety.

When one of them broke this week, I was surprised to find myself feeling happy about it, even satisfied.

Was that a strange response?  Maybe, but here’s my thinking on it.

Like many people, I’ve had a tendency to set aside the “good dishes” (or fancy paper napkins, or special blouse), saving them for a special occasion.

Doing this means those precious items are rarely used and enjoyed, and more than once, waiting has meant that what was special has become ruined for some reason.

In the past few years I’ve developed a philosophy of using the things I love, even when it means risking wear, tear, and ultimately the end of the object.

It feels like I’m no longer depriving myself, and every day is graced with little reminders of the things that give me joy: a special color or pattern, the glimmer of crystal, wonderful memories.

I used to be a person who saved the cherry on a sundae for last.

Now I eat it right away, and I’m not above asking for two cherries!

Are you saving something for a special occasion?  Today is special!  Life is short and we should embrace every moment for the blessing and gift that it is.

http://www.powerfinish.com/powerpoint-templates.htmlOpen those Christmas presents and enjoy them – now that’s a resolution you can live with!

 

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Lisa Kendall is an expert in Elder Care and self-care for all members of the care partner team.

We wish you much Joy and many Blessings in the coming year!

lisa@lisakendallcounseling.com

Sorrow and Joy in the Season of Light

I am thinking a lot in this season about loved ones who have passed, and in particular about my daughter, Diane, who died almost 17 years ago in a car accident.

Through much of the year I am able to stay busy with meaningful work and beloved Diane Graduationfamily, but there is a bittersweet aura around the winter holidays that forces me to look at my loss and care for my broken heart.

I know others are grieving too.  Perhaps you’ve lost a parent, sibling, or child, or know someone who has.  Most of us have lost friends.  Perhaps you are caring for a loved one whose illness triggers feelings akin to grief.

While we encourage people to celebrate the joys around them, hold fast to memories, and embrace what is present in our ill loved ones’ lives, this is a time to also honor those who have gone before and those who love them.

Every year I remind folks about the Worldwide Candle Lighting hosted by The Compassionate Friends, an organization that offers peer support groups for bereaved parents, siblings, and grandparents.

The Compassionate Friends group in Binghamton, NY probably saved my life after Diane’s accident.

I encourage you to visit their website at www.compassionatefriends.org, and to participate with me in lighting a candle for our children who have died.

http://www.compassionatefriends.org/News_Events/Special-Events/Worldwide_Candle_Lighting.aspxThis annual ceremony starts at 7 p.m. on the second Sunday evening in December, and by lighting a candle in your time zone, wherever you are, we create a wave of light that ripples around the world for 24 hours.

This year’s Candle Lighting is on Sunday, December 8th.

Thank you to all who have supported me with their encouragement, prayers, and good wishes.

Thank you to all who are doing the hard work of caring for ill loved ones.

It helps to know we do not walk alone.

Celebrating Thanksgiving with Loved Ones who Live with Dementia

Thanksgiving is a very special American holiday that carries many memories and not a little nostalgia for the past.

I remember riding in our family car with my sisters to visit Grandparents for Thanksgiving, and singing “Over the river and through the woods, to Grandmother’s house we go!”  It’s a warm memory, infused with laughter and excitement.

Memories are at the heart of this holiday, which is focused on gratitude.

This year for Thanksgiving, you may want to consider a shift in your traditional way of looking at your Loved One who is living with dementia, and the ways they contribute to your family.

Consider your Elder’s strengths, and the gifts they offer, and actively express your Gratitude for them.

Instead of just remembering with sadness the grand meals your Elder used to make, be sure to experience gratitude for the memories, the recipes, and the ways your Loved One contributes to this years’ experience.  It will give her great pleasure to “teach” her favorite dishes to the younger set, and to help at whatever level she can and in a way that ensures success.

Autumn Tree SunsetInstead of focusing on illness, have the family create a list of gifts your Elder has given over the years and continues to give.  For example, a grandchild might write “I am grateful for the way Grandma has helped me with college, and for her encouragement in my studies.”

Share this list with the Elder in a packet of notes, so she can refer back to them.  This will make the moment last!

Focus on Laughter; it’s the greatest gift we can share among family and friends.

Consider a smaller group to cut down on noise and confusion for your Loved One.  Your Elder’s strength might now be to enjoy more intimate gatherings.

Provide a place for the Elder to step back and rest whenever she feels the need.  This might be a comfortable room where she can nap, or a second living space, such as a family room or den, located away from the bustle of dinner preparations or rowdy football games.

Remember the other care partners in your Elder’s life, and show your gratitude for them.  A card of thanks is a valuable gift to home health aides or the neighbor who keeps the walks cleared in the winter.

Stimulate memories and conversations by starting a story with, “I remember when we (did such and such…) It was always fun to be with the cousins,” instead of asking the Elder “do you remember…?”  The former is more likely to generate shared stories, while the latter can lead to frustration and increased confusion.

Seat your Elder next to someone who knows them well and is patient and kind.  They can watch for needs the Elder may have difficulty expressing, such as “pass the rolls, please!” or “may I be excused from the table.”  They can slow the conversation down so the Elder can participate.  Sometimes a little more time is all that’s needed.

Perhaps different family members can take turns attending closely to Grandmother or Grandfather, 30 minutes or an hour at a time.  This ensures that no one feels left out of that rowdy football game!

Some family holidays are day-long affairs.  Is this what works best for your older Loved One now, or should she come for the part of the day that is most meaningful and manageable for her?

Speaking of “meaning,” a guideline to help you decide what and how much to do for the holiday should be to ask what is meaningful for you, your Elder, and your family.  Stretching yourself to do extra cleaning or make everything from scratch might leave you feeling too tired to enjoy the gathering.

Where can you cut back on work, or delegate tasks, while keeping the most meaningful parts of your time together intact?  Is there a ritual your family does for Thanksgiving that you want to honor?  Figure out how your Elder can participate easily.

For example, a family who has always had each member read a verse or passage at the table might shift the custom to showcase the teens or the younger kids.  If your Elder’s reading is good, but recall is poor, she may be OK with reading something rather than reciting from memory.

What ideas do YOU have for enjoying Thanksgiving with your family, and for adapting to the needs of a Loved One who is living with dementia?

Please share your comments below, and have a Blessed Holiday.

Presentation on Care Partnership Truly is FREE!

Hi, All –

I’m sorry there has been so much confusion about the talk on Care Partnership I’ll be doing at Lifelong in Ithaca next Monday, November 18th.

Lifelong has let me know that the course is FREE of charge, but registration is requested.

Please call Lifelong at (607) 273-1511 for more information or to register.

Thank you for your patience!

Correction on the Care Partnership Talk…

Hi, Everyone – I must apologize for incorrectly posting the presentation I’m doing for Lifelong in Ithaca as free of cost.  There is a $10.00 fee for the program, per Lifelong’s new pricing structure.  Please let your networks know, and again, I am very sorry for the error.

Thanks and take care,

Lisa K.

P.S. If the fee is a barrier to anyone attending, please let me know.  It’s important feedback!

Care Partnership: Creating Meaning in the Giving and Receiving of Care

Monday, November 18, 2013 

10AM-12PM

Hosted by Lifelong, Ithaca, NY

Facilitated by Lisa Kendall

When we or our loved ones need some assistance due to illness or injury, we find that traditional models of care can create as much distress as the illness itself, leaving us feeling powerless and frustrated.

“Caregivers” report acute stress and exhaustion, and “care receivers” feel they have little to offer because of theiLisa's Kitchenr physical or cognitive challenges.

When we advocate for the well-being of the whole care partnership rather than seeing the needs of caregivers and care receivers as separate, we create empowered care partner teams that ensure the independence, dignity, and continued growth and development of everyone involved.

Learn about person-directed care and how to make care partnerships work for you, and tap into an international movement to change the culture of care for Elders and their care partners in this two-hour session.

Call Lifelong at 273-1511 to register for this informative presentation.

 

Receive your complimentary report on How to Assemble Your Care Partner Team at www.carepartnerconnection.com

Lisa Kendall is a clinical social work psychotherapist and clinical gerontologist who has worked with Elders and their care partners for over 30 years.  In addition to her private practice and public speaking, Lisa is an Educator for The Eden Alternative and teaches for the Ithaca College Gerontology Institute.  Contact her at lisa@lisakendallcounseling.com for more information or to schedule a training.

The Most Powerful Tool You Can Use in Caring for a Loved One Living with Alzheimer’s

Dementia of any kind, including Alzheimer’s disease, can be very frustrating for families or professionals who are trying to provide care.

Early in the disease, people living with dementia might have difficulty finding the word they mean to use, or forget names of close friends and dates of important events.

As the disease progresses, it may become even more difficult to express feelings or make needs known to others.  People who have trouble expressing themselves become frustrated and even angry.

It’s easy to make two mistakes when this happens:

First, we might assume that the use of the wrong name or incorrect date means that the person has forgotten their loved one or the event.  In reality, they may know who and what they’re trying to discuss, but the correct word doesn’t come to them.

We’ve all had this happen, haven’t we?

Second, we may see angry behavior as coming from the disease, as opposed to a very natural frustration at not being understood.

http://astore.amazon.com/lisakendallcounseling-amazon-store-20/detail/193252956X

 

Dr. Al Power’s book, “Dementia Beyond Drugs: Changing the Culture of Care,” talks about several different kinds of communication problems that can accompany dementia, and challenges us to change how we look at and deal with them.

You’ll want to take a look at his book, which focuses on care in residential settings such as nursing homes, as the principles apply to Elders who live anywhere.

 

Naomi Feil, a social worker who created “Validation Therapy,” teaches us to acknowledge the feeling that’s being expressed, rather than to take on the logic (or apparent illogic), of what the person who lives with dementia is saying to us.

This approach works well for routine communication as well as for those situations where someone appears to be delusional.

For example, when Mary says she wants to see her Mother, who has been dead for a long time, it does no good, and may do harm, to remind Mary that her mother has been dead for many years.

A more helpful approach is to acknowledge the feeling that is being expressed. 

If the person seems sad, you can say, “it sounds like you’re missing your Mom.  Could you tell me a little more about her?”

This approach honors the person and helps them feel heard and understood.  The invitation to talk more about the mother can lead to wonderful stories, and help the Elder feel less alone.

You can learn about Naomi Feil’s approach at her website; just click HERE.

http://astore.amazon.com/lisakendallcounseling-amazon-store-20/detail/1572242701

An easy book to get you started with this technique is “Talking to Alzheimer’s: A Simple Way to Connect When You Visit with a Family Member or Friend,” by Claudia Strauss.  It’s a small book written for everyone, with easy to understand examples of what to say, and what not to say.

 

Truly hearing an Elder who lives with dementia is a powerful way to honor them and help them connect with you and ensure that all their needs, physical and emotional, can be met.

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Please be aware that if you purchase books from the above links, a small percentage of the cost will go to support this website.

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Be sure to leave your name and e-mail in the box at the top left of this page, so we can make sure you receive new blogs and updates about resources!  You will also receive my free report on “The Art & Science of Elder Care: 12 Tips to Help you Transform Your Caregiving.”

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Lisa Kendall is a clinical social worker and clinical gerontologist in private practice.  She teaches for the Ithaca College Gerontology Institute and is an Educator for The Eden Alternative.  Lisa speaks on Aging and Elder Care issues around the country. 

News from The Crossroads

It’s been a while since I last wrote, but a lot has been going on with me and Crossroads Counseling and Consulting.

I’ve added a new service you will want to know about; Care Partner Coaching is now available worldwide for  a limited number of professional or family caregivers.

I have been busy with trainings for The Eden Alternative in upstate New York and Wisconsin, facilitating a “Certified Eden at Home Associate” training and “Dementia Beyond Drugs.”  I also appeared  as a panelist on a webinar for The Eden Alternative on “Facilitating Empowerment,”

I will be appearing on Chris MacLellan’s “Be a Healthy Caregiver” Blog Radio program on Tuesday, July 9th at 1 p.m. Eastern time.  Don’t worry if you miss it, this generous and committed care partner archives all of his programs!  Chris has also written a blog about the show, which you can read HERE.

Video call snapshot 46

Private counseling services are still available at my Ithaca, NY, ADA-compliant office.  Availability is tight, so contact me soon if you are interested.  You can feel better!!

I trust things are going well with you, and hope to hear from you about how you’re doing on your care partner journey!

As always, you can reach me at crossroadscounseling@hotmail.com or (607) 351-1313.

 

Take care,

Lisa K.

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