February/March 2011 Print - Aging Well Eldercare

Dad is so thin!

It’s unsettling when a family member is losing weight unexpectedly. If the doctor has no medical explanation, perhaps it’s the result of one of these common situations:

Access to food

Money. Many elders needlessly limit purchases. A review of the budget, or shopping together, may help. If finances are limited, contact your local Area Agency on Aging to find senior dining programs and food banks.
Shopping. Your parent may have difficulty getting to a grocery store. And difficulty carrying packages. Have your parent try using a wheeled cart. Arrange for rides. Order groceries delivered. Or consider a taxi.
Cooking. Cooking is physically demanding. Standing. Lifting. Carrying. With arthritis or vision loss, simply opening a package can be difficult. Help prepare meals in advance. Or identify shortcuts, such as precut vegetables.

Appetite and eating

Flavor. We lose taste and smell as we age. And salt-restricted diets are often bland. Suggest cooking with more herbs and spices.
Pain. Pain decreases appetite. Eating with others can create a natural distraction. Also check for correctable problems with dentures or teeth.
Depression. Feelings of sadness, hopelessness, or loneliness commonly reduce appetite. Have your loved one evaluated for depression. Look for ways to reduce isolation, particularly at mealtime.
Medication. Some medications cause nausea or constipation. Others bring on a depressed mood. Still others reduce taste and smell. Ask the pharmacist about side effects and possible alternative drugs.

Memory loss can result in forgetting how to cook, not recognizing hunger pains, or not cooking out of fear of leaving the stove on. Consider having meals prepared and delivered.

Overuse of alcohol leads to loss of appetite and malnutrition. But a bit of alcohol with a meal can stimulate appetite. Strive for balance.

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Family Caregiver Happiness Project

Happiness is universally desired. But do you know how to increase your happiness? In his book, Stumbling on Happiness, Harvard professor Daniel Gilbert explains that it’s not about big goals or events. The better house, the extra-long vacation, don’t really make us much happier.

Instead, happiness is closer at hand. It evolves from our day-to-day experience. Little achievements, a shift in attitude, a pleasant activity, all add up to more cheer. The sum total of little victories results in a better overall feeling about life.

The Caregiving Happiness Project is currently exploring how family caregivers can create happiness despite ongoing stress.

You can participate in this study! The project supplies a monthly theme and an online support community. Themes include simple ideas such as “space,” “quiet,” and “learn.” For example, here’s how two participants interpreted November’s theme of “let go”:

One woman challenged her belief that “uncomfortable behavior in dementia is never accepted.” When company visited, she reminded herself to “let go.” She relaxed about her mother’s behavior. And she found that “it was okay; her challenges were accepted.”
Another participant decided to “let go” of old family photos. As she took the albums apart, she found pleasure in sending packets of pictures to other relatives to enjoy.

The goal is to explore simple strategies and find the ones that work for you. Participants use surveys that measure their happiness when they start the project, and again at its finish. To assess the impact of happiness on health, they are also checking their blood pressure and weight.

Empower yourself to get more joy from your life. Don’t wait for happiness to arrive “once things settle down.” Check out the Caregiving Happiness Project. Or create your own simple strategies to make your day better, starting this moment.

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What is hoarding?

Perhaps you wonder if your family member is a “hoarder.” You may even harbor secret fears about yourself! We all have cherished possessions. From trophies to teacups. Spare buttons to cans of half-used paint.

To save things is normal. To hoard compulsively is not.

Most of us can determine when we have “enough.” And we can decide to stop buying things and/or start donating or recycling things or throwing them away. Hoarding is different. The formal definition of a person with a hoarding disorder is a person who

acquires and fails to discard a large number of possessions that appear to be useless or of limited value
lives or works in spaces so cluttered they cannot be used as originally intended
has significant distress and/or problems in everyday life that are caused by the hoarding behavior

What’s “normal” in home clutter occurs across a spectrum. The disorder of hoarding falls at the far end of this spectrum:

Clutter free
Clutter
Social impairment: problems in everyday life, such as inability to find bills that must be paid, can’t invite friends or family to visit
Safety issues: piles on the floor create a falling hazard. Belongings stacked on top of each other create a fire hazard
Squalor/health hazard: infestation by mold, bacteria, insects, or rodents. (At this late stage, the local fire department and/or Adult Protective Services typically begin an intervention.)

It’s common to think that a person living in a cluttered environment simply needs some help “cleaning up.” Unfortunately, it’s not so simple. People who hoard compulsively cannot get rid of their stuff. It’s a disorder, not a decision.

Families who try a “let’s just do it!” approach usually end up estranged. Next month, we’ll outline signs of a hoarding problem and strategies to help reduce the chance of conflict.

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