Water Therapy for People with Neurological Disorders

Dear Caregiver Coach: A friend of mine recently told me that there is a water therapy program that might help people with reduced mobility recover some of their mobility. I understand too that it can be helpful and give positive results when used with a person who has Alzheimer ’s disease or someone who has Parkinson’s. Have you heard about its use with these groups? Signed: Wanting to Swim

Dear Wanting to swim: Yes, I have heard of the effectiveness of this kind of therapy especially with folks who have Alzheimer’s Disease or Parkinson’s Disease. The Continuing Care Community in Sun City, Royal Oaks, has had a water therapist who was very successful with his work. They have a video of a particular gentleman who had very advanced dementia. This man was not communicative and was often slumped in a wheelchair. Putting him in the warm water at the pool at Royal Oaks proved to be remarkable. After a few sessions, the man was able to move limbs more easily and even to communicate and make eye contact that previously had not been possible. If you want to read more of the research published about this occurrence, go to this website: http://www.royaloaks.com/cmsdocs/Aqua_therapy_and_Alzhiemers_Disease-AGS-Annals_of_LTC_May_2013.pdf Dr. Marwan Sabbagh, who is a well known Alzheimer’s doctor in Maricopa County, and Dr. Holly Shill, a well known Parkinson’s Disease doctor in our geographic area, are both cited as part of the research team. Recently, a family which attends one of my support groups contacted the facility and enlisted the water therapy team for their daughter with early onset Alzheimer’s. She has already had 2 sessions with the water therapists, and the family is very happy to see how she enjoyed herself in the water. I hope this gives you some idea of the effectiveness of water therapy and how it can be used. Thank you for asking……..take care…….Regina


Driving When Impaired

Dear Caregiver Coach: I find that more and more I have to tell my loved one where to go when we are driving together. He is forgetting where to turn and even sometimes when to stop. When is it time to take away the keys? Signed: Responsible Driver
Dear Responsible Driver: That is a very important question for those of us living in an area where there is a high population of seniors. If your loved one has been diagnosed with a cognitive deficiency like Alzheimer’s, vascular dementia, Lewy body disease, Parkinson’s, and more, you should speak with your insurance company to see if this affects your insurance. Ask then what they would cover should your loved one be in an accident. You may be surprised at their answer. Also, when you next visit with your family doctor, ask him/her this question as well. That person may be able to assist you with taking away the keys. Often, a doctor is in a position of authority that many people will not challenge. Also, here are some tips for when that time may occur which might help you decide:

Tips: Is It Time to Stop Driving?

Forgetting how to locate familiar places
Failing to observe traffic signs
Making slow or poor decisions in traffic
Driving at an inappropriate speed
Becoming angry or confused while driving
Hitting curbs
Using poor lane control
Making errors at intersections
Confusing the brake and gas pedals
Returning from a routine drive later than usual
Forgetting the destination you are driving to during the trip

The DMV can also help. Bring your loved one in for a driving test and let the employees there know that your loved one has a particular diagnosis. They may be able to cancel his license and give him an ID card to use instead. I hope this helps with your decision.
Thank you for asking this question, because it is something we all need to consider for ourselves as well as for others……..take care…….Regina

Important Papers

Dear Caregiver Coach: My friends and family keep telling me that I need to get my important papers and business affairs in order. I am a caregiver for my husband who has always done the paperwork for us. I am at a loss as to what papers I need to have in order for us. Can you help me? Signed: Piles of Paper

Dear Piles of Paper: Your friends and family are correct. Having one’s personal and business papers in order and in a place where they are easily accessible is always a good idea. If something should happen to you or your loved one, things can happen quickly and it can be a time of stress. In moments like these you do not want to have to worry about finding appropriate paperwork. With that in mind, here is a list which might start you getting those items in order:
1. Bank accounts and check numbers – You may also want to note where hard copies of checks are being stored, if applicable. Keep a record of who the beneficiaries are if designated.
2. Birth certificates – If you can’t find yours, you can order an official copy from the city or town in which you were born.
3. Brokerage account numbers, account Websites and passwords, broker contact info. Most brokerage accounts have online account information that can be easily accessed.
4. Computer/Website passwords – These are important for your executor to have in order to close down any open online email services, subscriptions, PayPal accounts, online bank accounts and the like.
5. Family contacts – Provide the contact information of professionals who have assisted the family and who the executor will likely need to contact.
6. Health records – Provide your executor with all personal health records: This information will be important to the future generations of your family.
7. Home alarm code and location of instructions – It could be pretty embarrassing for your executor to trip off your alarm or not know how it works should you not be around.
8. Insurance policies – Make sure life and health insurance policies can be located along with any agent or company information.
9. Military discharge papers – These will come into play if military benefits are due to your beneficiaries.
10. Organ donor – If you are a donor, without proper documentation, your wishes will not be observed.
11. Safe deposit box number and key – Some have one safe deposit box, others have many. Regardless of your situation, make sure you leave clear instructions as to where yours is/are and how the executor can access it/them.
12. Social Security number and card – This is important for identification and benefit claims – not just your Social Security number, but those of your beneficiaries, including minor children.
13. Trust documents – If you have created a trust, regardless of type, your executor will need to be able to locate and access the governing documents.
14. Power of Attorney, Living Will and other important documents can be found for free online at the Arizona Attorney General’s office: https://www.azag.gov/seniors/life-care-planning
I am sure you may have other items you want to include on this list. I hope this will help get the process underway for you which will lead to more peace of mind. Thank you for asking this question; it is important for all of us to get our paperwork in order……..take care……..Regina

The Importance of Controlling Caregiver Stress

Dear Caregiver Coach:

Sometimes I feel like I just want to jump out of my skin I am so frustrated and stressed with having to care for my Mom 24/7. I left my part time job so that I could help Mom who moved into our home last August. Since then, my husband and I have made room in our lives for Mom and I have tried to be the good daughter and meet as many of her needs as I can. However, she has the beginning stages of dementia and is forgetful and needs things repeated over and over. Plus, she follows me wherever I go even to the restroom. I get quick tempered with her and don’t like myself for that. I am getting close to Social Security age and want to protect my health too. Any suggestions?

Signed: Skin Jumper

Dear Skin Jumper:

I am sure there are many readers of this column out there who can empathize with you. 24/7 is a lot, and even the most considerate of us find the fuse is shortened with that kind of responsibility. You are absolutely right to be concerned about your health too.

Often, a caregiver will let his/her health go while taking care of someone else. The current national health statistics say that about 60% of stressed caregivers can pass away before the person they are caring for.

Also, a recent study at the Albert Einstein College of Medicine in New York City said that “those individuals who had high stress levels were more than twice as likely to develop cognitive impairment as those who did not.” You want to be aware of that statistic and the other statistic and address your needs too.

Relieving stress is a concern for those of us living in the second millennium. One thing you can do for you as well as for your Mom is to consider having her attend a program for those with cognitive impairment. That would give you both time apart and would give her a place to meet friends and have social stimulation she may not have at home. DUET and Benevilla are two places that provide that kind of care. If that is not for her, consider asking a relative or friend to come and play cards with her or work on a simple puzzle with her so that you can go out for an hour or more to have coffee with friends. Socialization is important for you too. Often caregivers let their social lives slip away while caring for a loved one. Another option is to hire a home care company which can provide in home companion care for Mom if that is indicated. That way, you could have an even larger quantity of time to do something more just for you.

Exercise is also important for you both. While we have these warmer days and before the real heat begins, take her for a gentle walk around the neighborhood. Being outside is stress relief for you both.
If you can find a support group close to you, that would be a great place to talk with others in your same situation. Benevilla has many that are free and open to all. Sharing is a great stress reliever, and you may find new friends as well. I hope that gives you some ideas which may help. Take care of yourself too……….Regina

Snoozing and Brain Health

Dear Caregiver Coach: I am weary since I am a full-time caregiver for my sister who has health issues and who needs my assistance with her activities of daily living. I don’t sleep well at night, but I find that I could nap in the middle of the afternoon if I allowed myself. I am afraid that napping will just make me less attentive and may make me groggier. What do you think??
Signed: Groggy

Dear Groggy: As you have seen me say many times, if you have any health issues that might concern you, like not sleeping well, always check with your primary care doctor to see if there are any underlying issues that maybe he/she can help with.
That being said, there has been research done and some of those results were published in the February edition of “Neurobiology of Learning and Memory.” This is what was reported: “A brief daytime snooze can boost your memory fivefold”……researchers discovered that when participants in their study were retested after one part of the group had napped for between 45 and 60 minutes, those who napped “performed as well as they had on the earlier test and were five times better able to recall” some word pairs “than those who had not napped. The scientists say their findings suggest that when it comes to associative memory, the ability to remember a link between items that are unfamiliar and unrelated, such as the name of a newly introduced acquaintance, a snooze is enough to significantly improve learning success.”

To put all that in simpler terms…….yes, try taking that nap and see how you feel afterwards. It may just be the help you need! Take care; I hope this helped………..Regina

Housing Options

Dear Caregiver Coach: I am concerned about my future and my loved one’s future. We are ok at this point, but my loved one has MS and worries that she may need more care. I picked up the PACE book magazine at the local library, and although it was very helpful, I am overwhelmed with the amount of choices. How do I winnow down those choices? Signed: Too Many Options
Dear Too Many Options: I understand your being overwhelmed. However, the Area Agency on Aging in Phoenix does a very good service by providing us with that PACE book. If you browse through some of the first few pages, there is even a check list that helps you start to determine what your needs might be. Here is a description of some of the major categories of living options which came from our Benevilla CARES partners.
1. Facility/Community: provides housekeeping, meals, maintenance, utilities, activities and transportation. These services are typically included in the monthly fee; however, this can vary from one community to another. So, you will want to ask each one what they include.
2. Congregate/Independent Living Community/ Group Homes and like Facilities: Private room, studio, one or two bedroom apartment, sometimes with a kitchenette or kitchen privileges.
3. Licensed Facility/Community: In order to provide assistance with the activities of daily living, a facility must be licensed by the State and must follow the established regulations and pass regular auditing by the State regulators.
Assisted Living: Within the same environment housekeeping, meals, maintenance, utilities, activities, transportation services are provided in additions to assistance with ADLs.
The 3 levels of assisted living licensing are supervisory, personal care and directed.
All are required to have oversight of a nurse and/or a doctor.
a. Supervisory = staff awareness of and monitoring of the resident’s status
b. Personal Care = assistance with bathing, dressing, toileting, etc.
c. Directed = memory care

4. Care Centers/Long Term Care Centers: these are often referred to as Skilled Nursing Facilities (SNF). They provide non-hospital medical care. Short term care can be either through insurance or private pay. If long term care is required this too is possible, however it will be done with private pay only.

I hope this is of some help to you. Please email me if you have further questions. Also, consider a Senior Placement company to assist you if you feel the numbers are too confusing. Take care……Regina

When Traveling, Call TSA!!

Dear Caregiver Coach:

My husband who has Parkinson’s dementia and all the movement difficulties as well and I are traveling to visit family in Minnesota soon. I am concerned about my navigating the airport with him. Who can I call? Do you have any suggestions for us which will make it easier for me?

Signed: Worried about Travel

Dear Worried about Travel:

Getting around the airport is time consuming and can be more challenging for someone with disabilities. To save time, and to help you and your husband make your experience less stressful, there is a number you can call here in the Phoenix and West Valley area which will lead you to some folks who can help.

First, of course, the airlines themselves can be very helpful if you contact them in advance. However, the agency which can be a source of great help would be the TSA or the Transportation Security Administration. They are the folks you see when you are going through security to get to your airplane’s gate. They check your ID and your carry on luggage, etc. I think many people are not aware of how much help they can provide.

You do need to call them 72 hours in advance at their toll free number: 1-855-787-2227. In addition, you can request a “passenger support specialist” ahead of time by calling the TSA Cares helpline at that same number. This specialist will meet you at the curb and take you through security to your gate with a minimum of difficulty. The helpline is available Monday through Friday from 8 a.m. until 11:00 p.m. EST.

You can also email TSA at TSA-ContactCenter@tsa.dhs.gov with questions. In addition, at their website, you can download and read more information about this wonderful program. One of the caregivers in my support group recently traveled with her elderly mother and found TSA most accommodating.

The caregiver and her Mom were able to go through security easily, quickly and with a minimum of difficulty. Thank you for asking this question which may help others concerned who will be traveling with a loved one with a disability.

Take care and happy travels………Regina