Ask the Nurse | Caring for a Parent

When it's your Mom, everything changes

by Christine Hammerlund, President of Assured Healthcare and "Mother"

You can become accustomed to the professional detachment of nursing. I've spent most of my adult life in that role and finding just the right balance among intellect, knowledge and emotion is one of the toughest hidden “jobs” of health care.

Good people care. You cannot hide from being human. But nursing means being smart in choices. Being smart and attentive for your patient is a never- ceasing quest. Medicine might be a science, but healing is an art.  

Meet Virginia ,  one of our patients and mother of Assured Healthcare Staffing owner Chris Hammerlund.

Meet Virginia, one of our patients and mother of Assured Healthcare Staffing owner Chris Hammerlund.

A good nurse must listen to many voices inside her head, each asking for attention and validation. But I thought I had mastered the art of that heart/smart balance until I confronted the future for my Mom.

When it's Mom, everything changes, and even a nurse cannot shield herself from deep fears and concerns. Even a good nurse can be fooled by signs she does not see.

So, this is the first of four part series about me and my Mom. This will be a shared experience for us - you and I.  You see, the time had come to make some decisions about Mom's day-to-day health, and we all experience this, ready or not.

I can tell you right at the beginning that sharing the burdens of life can be a difficult task. But maybe you will see your life - your Mom or Dad - in this picture.  Maybe it will help to know you are not alone. It did for me.

First, Mom is a wonderful person. I won't tell you her age because it would be embarrassing to her, but let's just say she's old enough to remember runningboards on cars and phonographs that sped around the record turntable at 78 revolutions per minute. She is a proud person and independent. And smart.

But these are difficult times for her and for me.

I will have to care for her now. That much is certain. I don't know how much I had focused on that likelihood in other years, but when the time comes, there is no escape from that fact if you care.

My Mother has a few issues that make her care very challenging. She has macular degeneration (reduced eyesight), hearing loss, very unsteady gait and moderate dementia.

The changes that age can bring don't happen in one day. It's often a slow, steady progression. I did not see that slide at first.

When Mom was still at her home living alone, she was able to hold it together through a phone conversation, covering up her dementia and leading me to believe she was just forgetful.  

She then had a very serious fall, which landed her in the hospital for a week and drove my decision to have her move into my home. What I have found since she began living with me is how limited her ability is to function without help.  

I would suggest to others that have the responsibility of taking care of elderly and infirm parents or loved ones, first trust your gut.

And second, bring in a health care professional.  

By “trust your gut,” I mean that when you think something is wrong, it probably is worse than you think.  Second, either get in touch with the Doctor or have a nursing assessment done. Nothing is as useful as an independent evaluation of how well the senior performs activities of daily living and exercises their cognitive awareness. A doctor or independent nursecan see what you cannot.

The first job is to realistically determine whether it's safe for them to continue living alone. You have to become smarter about Mom. I did. It was the first lesson I had to learn.

As part of my business, I hire and manage home health care nurses all the time. I'm doing that now. If anything, the experiences with Mom have helped me see what those nurses need to know.

Next month, part 2 next: How did we wind up here?


Celebrate American Heart Month

Heart disease is the leading cause of death for men and women in the United States. Every year, 1 in 4 deaths are caused by heart disease.

The good news? Heart disease can often be prevented when people make healthy choices and manage their health conditions.

Communities, health professionals, and families can work together to create opportunities for people to make healthier choices.

Make a difference in your community: Spread the word about strategies for preventing heart disease and encourage people to live heart healthy lives.

How can American Heart Month make a difference?

We can use this month to raise awareness about heart disease and how people can prevent it — both at home and in the community.

Here are just a few ideas:

  • Encourage families to make small changes, like using spices to season their food instead of salt.
  • Motivate teachers and administrators to make physical activity a part of the school day. This can help students start good habits early.
  •  Ask doctors and nurses to be leaders in their communities by speaking out about ways to prevent heart disease.

Identifying Dementia Symptoms in an Aging Parent

senior-man

Dealing with dementia symptoms in your own parent can stretch the limits of your sanity. Sometimes you may not even notice the first symptoms of dementia -- the slow decline of your aging parent's memory. The symptoms of dementia may continue until your aging parent starts exhibiting signs of other mental disorders, such as paranoia or delusions, which frequently piggyback on the effects of senile dementia. These symptoms may keep reappearing, until you can't ignore them and you're forced to take action like I was. Hopefully, this article will help you identify dementia and other mental problems in your aging parents and help you deal with the problem by getting their condition assessed by a professional. My own mom taught school most of her life. She was highly organized and extremely independent. She read constantly and became quite adept at oil painting. At the age of 76 she moved closer to my sister and I, but her canvases and brushes never seemed to make it out of the moving boxes. I bought her a VCR for Christmas, hoping that renting movies could help her shake her newly-found disinterest in life. But the new VCR was never turned on unless I happened to visit with a movie in hand. It became, like the microwave I had gotten her a year earlier, another piece of unused technology. It never dawned on me at the time that my mom had stopped wanting to learn new things, or that this could mean that her aging mind was showing early symptoms of dementia.

Believing that Mom's depression was a result of her unhappiness with her living situation, my sister and I began a search to find her senior housing. We placed our hopes on a retirement community that offered a full-time social director to rescue her from the depressed mood we were fighting. The retirement home helped her find new friends and subdued the paranoia, but only temporarily. Soon she insisted we change her banking accounts. She accused the banks of stealing money from her safety deposit box. She also became absurdly paranoid about my brother-in-law, who she suspected, had a master key to her apartment. All missing items were blamed on this poor fellow. We never suspected that paranoia could be a symptom of dementia.

The amazing part of all this is that my sister and I continued right on with our lives, denying Mom's odd behavior while helping her change bank accounts and get new locks for her apartment. We just figured it was normal for our aging parent to become strange when she turned 80 years old. We never suspected dementia was taking her away from us.

Symptoms of dementia are insidious, because they start so slowly. Often they are mixed with periods of what appears to be normal behavior. So just when we thought she was showing symptoms of dementia, she'd return with what appeared to be complete clarity, asking us about our spouses and giving the usual motherly advice we had grown up with and trusted. Looking back, I can clearly see the progression of the disorder. But at the time, senile dementia sneaked in and stole Mom from us without a clue. Because of our busy schedules, hectic lives, and maybe a little denial, we didn't see it until it was too late.

There was also a strong fear going on. I remember thinking that if my mother was showing symptoms of dementia, I must be showing symptoms of dementia too. She was so close to me that I had a lot of her same thinking patterns. She dictated reality to me when I was growing up. I worried about this a lot. I really wanted her to be "normal" so I could feel normal. I didn't want anyone to find out my mom was acting crazy. I could just imagine everyone at work hearing the news and moving their fingers in circles around their ear saying "Ah ha! That explains it!"

So we took Mom to doctor after doctor trying to find a cure for her symptoms. Was it low iron, low zinc, or low potassium? They drew countless pints of blood trying to rule out what could be causing her behavior. But eventually, most of the doctors proved worthless in offering real help. Not one seemed to be able to tell us what was wrong. None of her five doctors could give us any advice that would help her. They all seemed to deny there was any problem. Fortunately, we met a geriatric counselor who advised us to take her to a local hospital for a geriatric evaluation. I wish we had done this evaluation five years earlier.

If your parent is acting strange and you're not getting results or a concrete diagnoses from your doctor, consider a geriatric counselor. You can find them in the yellow pages or on the Web. The small amount of money you'll pay for their services will help you retain your sanity through the decisions you'll soon be facing. A geriatric counselor will also relieve you of a fair amount of guilt as you carry out the future decisions that become necessary when an aging parent develops dementia.

William J. Grote is the author of the book "Helping Your Aging Parent -- A Step-by-Step Guide". William cared for his aging mother and made plenty of discoveries along the way. Hopefully his book can help you down the road of care giving -- which for many of us who survived the 60's and 70's, may be a completely new experience.

You can download a free checklist "Warning Signs of Dementia and Mental Illness" to help you identify unusual behavior in aging parents at http://www.boomer-books.com