Caregiving and Dementia

Most common challenges associated with caring for a loved one with dementia:

  • Sleep problems and caregiver exhaustion are two of the most common reasons persons with dementia are placed in nursing homes. Causes of sleeplessness in dementia patients include pain, lack of exercise and activities, anxiety, agitation, or too much fluid or caffeine late in the day.
  • Urinary incontinence is the second leading reason that families institutionalize their loved ones with dementia. Urinary incontinence in persons with dementia should be evaluated for treatable causes, including urinary tract infections, electrolyte and calcium abnormalities, pro-static hypertrophy, and estrogen deficiency. A regular toileting schedule at two to three-hour intervals or verbal prompting may also alleviate this symptom.
  • Agitation and aggressive behavior have been reported in 65 percent of community-dwelling persons with dementia. Reasons for agitation or aggression include over-stimulation, physical discomfort, unfamiliar surroundings or persons, complicated tasks, and frustrating interaction, as well as more serious reasons as paranoia, delusions, or hallucinations.
  • Caregivers may be embarrassed or ambivalent about discussing inappropriate sexual behaviors exhibited by persons with dementia.
  • Persons with dementia are often reluctant to stop driving when safety is at issue.
  • Repetitious questions may be due to short-term memory loss and an under-stimulating/over-stimulating environment leading to anxiety, feeling out of control, or fear.

It is OK if caring for you to seek out housing options for your loved one, even if you promised you never would.  Caring for someone with dementia can be overwhelming when they are in a memory care facility, much less in their own home.  Seek out professionals who can help you find the right option for your loved one and that is convenient for you.  You were never meant to do this alone!

Information cited from the Alzheimer’s Association website

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Summertime tips for Caregivers

Seniors are especially at risk in high heat situations. Large stretches of the USA are experiencing extreme temperatures.

Here are some summer heat tips for helping elderly loved ones avoid heat stroke or heat exhaustion

  • Encourage fluid intake.* Water is best.  Pick up some bottled water to keep in their fridge.  It’s easy to grab and can help them track their water intake. Some fruit has a high water content (such as cantaloupe) is also helpful.  Remind them that sugary drinks, caffeine, and alcohol act as diuretics so fluctuating those fluids with water is key.
  • Make sure their air conditioning is working and turned on. Whether in an effort to cut expenses or because many older adults, especially those on blood thinners, get cold easily, they may not have their air conditioning turned on.  However; they may not recognize that being in air-conditioning can help them avoid heat stroke/exhaustion.  Explain the reasoning behind having the air on and then find them a sweater to wear in the house.
    • If they do not have air-conditioning, consider going to a mall, movie theatre, museum or city cooling center.  Another option is having them stay with a family member until the heat wave passes.
  • Take a cool shower or bath, especially in the evening before going to bed.
  • Wear light-colored, loose-fitting clothing that breathes.
  • Discourage activities such as cooking/baking in the oven as well as thorough housecleaning during heat waves. 
  • If going outside, apply sunscreen and keep it on hand for re-application.
  • Regularly check in on elderly relatives, friends and neighbors in person if possible. If you live far away, contact another relative or neighbor who can stop by and check on them.

Know the signs of heat stroke (i.e.: flushed face, high body temperature, headache, nausea, rapid pulse, dizziness and confusion) and take immediate action if you or your loved one is having any of these symptoms.

For more caregiving support visit

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Reconciliation and Your Well-Being

Growing up my family was very close. In typical Italian style, every Sunday was spent at my grandparent’s home in Chicago where random aunts, uncles and cousins (most of which lived on the same block) gathered for an amazing feast. My grandfather, the middle child of 5 had a younger brother named Chris who I had never met. Chris was rarely mentioned and when he was it was with a tone of bitterness. Confused by the paradox between the closeness of the family and the outcast of one member I once asked my grandmother why Chris was not a part of our close-knit group. She quickly replied that there had been a “falling out” and then promptly changed the subject.

Unfortunately for my grandma, I had a simple, yet profound follow-up question, “what happened?” To my surprise, she didn’t quite remember all that had happened but knew that it was bad enough to “break up the family”. I later heard that the “incident” involved Chris’s wife making a comment to someone else about my grandma, which had then been relayed to my grandpa through a third-party and therefore caused the rift. Shortly before my grandma’s death my grandpa and his brother reconnected and reconciled, at this point neither could tell you why they had stayed apart so long.

I share this example because, as an adult, I comprehend that the 30+ year divide was based on hear-say most of which most likely included Italian dramatization of the actual event. To some this may seem extreme, however; in my 20 year career I have met hundreds of families torn apart by a random comment, perceived offense or imaginary conflict. Stressed out people, especially those caring for an elderly loved one can misinterpret the comments and actions of others. In many cases, instead of trying to clarify the facts a grand story is created about the other person’s actions and intentions.

When we are in conflict with others, the conflict is really where we are. Many times the other person doesn’t even know that there is a conflict. The stress from these family feuds, if allowed to fester can cause major health issues. However; if addressed in a timely manner can more often than not be cleared up quickly.

Points to Ponder

  • Is there someone in your family that you are in conflict with?
  • If you looked at the facts of the incident(s) that caused the conflict what part did you play in the conflict?
  • What would you have to “give-up” in order to resolve the conflict?
  • What would become easier in your life if you were no longer a part of this conflict?

To really answer these questions one must first leave their pride outside and take responsibility for their part in the conflict. However; if able to realistically evaluate the situation and allow yourself to forgive others and be reconciled with them, you will be amazed at how much lighter you will feel.

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Caregiving – Learning from the Past

It’s amazing how insightful we are about situations faced in the past. Why? Because once  the chaos has subsided and the situation is over, we can analyze it from a new perspective.

However; when in the midst of challenges in our lives, the physical and emotional mayhem causes us to function more in reaction to, as opposed to careful analysis of, the situation.

When caring for someone we love there are several factors that come into play when making decision

  • Our emotional reaction to what is happening to that person
  • Our personal dynamic with that person
  • Our perceived role in the life of the person that is ill as well as in the overall family (i.e.: our birth order)
  • Our understanding of what is happening to them health wise
  • Understanding what resources are available and how to utilize them

Having worked with family caregivers for over 20 years, written 2 books on the topic, as well as having cared for several family members, I can tell you first-hand that even when a caregiver knows what they are doing and how to access resources, emotional reaction and family dynamics can often overshadow the judgment of even the most knowledgeable of caregiver.

Points to Ponder

  • You don’t get a “do-over” so dwelling on what you should or could have done is an exercise in futility.
  • You did the best you could in the face of the overwhelming tasks and factors involved in caring for someone you love.
  • Guilt is an unnecessary emotion that we “put upon” ourselves once we are on the other side of decisions made. The good news is you have the power to remove the guilt (see Letting Go of Guilt).

Even if you grasp an understanding of these points, human nature triggers us to over analyze and dwell on situations thus inducing guilt over the shoulda, coulda, woulda’s we come up with.

What can we do to stop the madness?

Utilizing the new-found Genius

  • Analyzing the past can assist us in being pro-active about the future care needs of other family members (see Pro-Active vs Re-Active Caregiving).
  • Understanding the challenges we faced can benefit others around us who are in the midst of the caregiving chaos by sharing our story and lessons learned from the experience.
  • Our experience can assist us in being more aware of our reactive tendencies causing more focused and fact based decisions in the future. (see Fear vs. Fact)
  • Utilizing our experience to assist us in creating a plan for our own future care needs. (see Wrinkles Memory Loss and Erectile Dysfunction)

Most importantly – Keep reminding yourself that you did the best you could, considering what you were up against!

For more support and resources visit

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Best Mom Ever – Happy Mother’s Day

I have been blessed to have the best Mom in the history of Mom’s. Maybe I’m a bit biased (just a little), however; if you were to ask my friends from childhood through today about my Mom they would probably tell you the same thing.

me and mom

Most women have the ability to become a Mom (I unfortunately I was not one of them), however; I believe that some people are just born to be Mom’s. They have some kind of special DNA which makes them innately more gifted at the job than others. My Mom is one of those women born to be a Mom.

If you were to ask my Mom about herself she will talk about me, my sister, her grandchildren and son-in-laws without ever actually mentioning anything about herself. She always seems to be amazed at what a great family she has never realizing her love and support has been the cornerstone of our family.

She has always been my hero; facing the obstacles that life has thrown at her with strength and dignity (see One Word can Change Your Life). She is the kind of person who will show up for you when others are walking out on you. She will give you the shirt of her back and has literally given me the shoes off of her feet. She has taught me the meaning of unconditional love.

So in honor of her I want to share life lessons from my Mom.

  • A note of encouragement can make a huge difference in someone’s day (see Encouragement by Mail)
  • Always show up for others (even if you don’t think they deserve it)
  • Make family a priority
  • Family and forgiveness go hand-in-hand
  • Keep moving forward even when it’s hard
  • Unconditional love cannot be earned, it is given freely whether or not you think the other person deserves it
  • Encouragement is a gift you can give to anyone at any time
  • Be nice to everyone (AKA: kill them with kindness)
  • If someone doesn’t like you or want to be your friend it’s their loss not yours (this was one of my favorites)

Thank you Mom for all the love, support and encouragement you give so freely.

Happy Mother’s Day!!!

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Surprise – Mom got old!

It still amazes me how many people I have met over my 25+ year career that seemed genuinely surprised that their parent had gotten old.  Especially since the alternative to getting old would be death (not trying to be crass, it’s just the truth).  The reality is that barring an untimely death our family members, as well as ourselves, will all eventually be old.

When I speak to people about being pro-actively prepared for this approaching season of life share many will say that they are prepared.  When I ask for an example of their “preparedness” 99/100 times their example is their pre-paid funeral, to which my responses is “That’s great for when you’re dead, what do you have planned before that?”

While it is very helpful to have your funeral pre-paid, there are many other pro-active steps that can be taken to help ourselves as well as our family members before that.  I refer to this as preparation for “What if”.

Ask the following questions of your elderly loved ones (as well as yourself) and then encourage them to start gathering information on the local programs, facilities and care options available in order to empower them to make pro-active decisions about their care.

What if…

  • You needed to go for rehab due to a stroke or other major health issue, where would you want to go?
  • You were no longer able to safely live in your home where would you want to live?
  • You were unable to make decisions about your care would you want the procedures/options of care:
    • Resuscitation. Restarts the heart when it has stopped beating.
    • Mechanical ventilation. Takes over your breathing if you’re unable to do so.
    • Nutritional and hydration assistance. Supplies the body with nutrients and fluids intravenously or via a tube in the stomach.
    • Dialysis. Removes waste from your blood and manages fluid levels if your kidneys no longer function.

Write down the answers and then share them with all the family members.  When everyone is aware of the persons’ wishes ahead of time it makes it less problematic for the family if ever faced with making those types of difficult decisions. These are just a few examples of care related questions.  Having a place to start the conversation can help families share much needed information about individual preferences and help not only to create a practical plan for the future but empower pro-active personal decision making.

About the Author:

Sue Salach has worked in the geriatric healthcare field for over 25 years and has a Master’s Degree in Gerontology (the study of aging).  Sue employs her comprehensive experience and enthusiasm to assist corporations in creating innovative programs to reach out to employee caregivers in the workplace. She is a National Speaker and the author of two books, Along Comes Grandpa, a caregiving resource guide and If I Walked In Her Shoes  a caregiving novel. Follow me @SueSalach on Twitter.

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Caregiving and Corporate America

With the growth of the elder population, it is imperative that vital eldercare education be provided to family caregivers in their communities and workplace, as this growth pattern negatively effects caregivers in both their home and work life. According to a MetLife Caregiver Cost Study (2011), at any given time, between 25-35 percent of the workforce is caring for a chronically ill or aging family member. Some experts expect this statistic to increase to nearly half of the workforce within the next 5-10 years. Statistical data illustrates that issues related to caring for an elderly loved one are costing US companies an estimated $17 to $26 billion dollars annually in lost workplace productivity (

In other words: if employees are responsible for taking care of an elderly relative it WILL negatively impact their employers’ bottom line.

Due to the need to retain their income, family caregivers often come to work completely distracted and/or worn out. This is referred to as “presenteeism”. Presenteeism occurs when employees come to work but are unable to focus on their jobs. Workplace distractions are often triggered by an ailing family member in need of periodic check-ins throughout the day as well as assistance in household management along with coordinating doctors’ appointments and support services. Presenteeism for whatever reason, results in poor productivity and can reduce a workers’ productivity by more than one-third producing a negative effect on a company’s bottom-line equal to or greater than absenteeism.

According an Eldercare Survey by the Society of Human Resources Management (SHRM): 47% of HR professionals report an increase in the number of employees dealing with elder care issues and found that companies without eldercare benefits stand to lose $2,500 a year per caregiving employee. However personal this matter seems, the complexities of managing work/life balance for working caregivers has a significant effect on a company’s bottom line due to lost productivity, workday interruptions, absenteeism, worker turnover and replacement, low motivation and other factors. Caregiving negatively affects morale, productivity, and costs. As a result of caregiving responsibilities, a tremendous amount of talent, loyalty, and institutional knowledge leaves the workforce every day – either temporarily or permanently.

Informal caregiving is the foundation of health, social and financial assistance for older adults in the community. It is possible to help family caregivers balance their work lives with family caregiving responsibilities by providing resources and programs that acknowledge the lives of employees outside of work through the implementation of eldercare wellness initiatives. Employees who take advantage of educational and eldercare resources in their corporate/work environment are more productive and less likely to report negative caregiving impacts on their work performance. Of course, the programs are only helpful if caregivers use them. Education, resources and programs implemented before a crisis arises is the most advantageous way to maximize benefits initiatives for everyone involved, including the care recipient.

For more information (and solutions) about Eldercare Initiatives in your workplace please feel free to contact me via email

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