Caregiving for elderly loved ones carries some inherent understandings of how day-to-day activity is managed. For the most part, decisions and choices that affect the life of the elder needs to remain in her/his hands. For the most part… so what are the exceptions?

Based on our six-month experience, these are some guidelines that make sense:

• Decisions about simple things like what the elder is going to wear are left up to her/him… except… except when she wants to put on a long flowing skirt that now comes to the floor and would likely get entangled in her legs and cause her to fall. Mother was still mobile the first three or four months of caregiving. She used a walker. One day she wanted to wear a long-to-the-floor heavily gathered skirt. It was a safety issue that she could not comprehend but she insisted on wearing it. I gave in, and within an hour of dressing, it was badly soiled from her incontinence. I hadn’t even thought of that issue because she was such a high fall risk that that falling seemed to overrun all the other concerns. That was the last time she wore that skirt. The closer we got to her total dependence on us, the more she gave in to my statement, “Let’s pick out something that is easy to get on and off and easy to wash.”
• Many elderly loved ones receiving family care want to be helpful and do as much as they choose, or should I say, as much as they think they can do. This is a daily challenge for the caregiver. Many of the things Mother wanted to do increased her risk of falling… scooping the doggie pooh in the back yard, folding and putting away clothing, helping prepare meals, helping clean up after meals and do dishes, making her bed. All these activities were particularly dangerous for her in our living situation. For example, there is one path around an island in our kitchen, and only enough space for one person to work. She fell about every other day for the first 10 weeks into caregiving. And she generally was attempting to do something that with good judgment and appropriate problem solving, she would have chosen not to do. The challenge for us was to try to help her understand why her desires were not safe, and when that didn’t work, to say No and help divert her attention to something else. It was a constant and daily challenge. It never stopped until she was bedridden.
• The elder needs to be able to choose their route to death. We’re not talking about suicide or self-euthanasia; that is another topic entirely. The issue we’re raising here is the elderly loved one you are caring for has the right to tell you they do not want to take medication any longer. They have the right to refuse food and water. The day comes in the lives of many care receivers when they are tired and do not want to live any longer. As difficult as that is for us caregivers, we need to respect their choices. In our case, we made sure the primary care physician and Hospice team were notified and in agreement. Mother decided to stop taking her medications. Forty-two days later, she died. She had the right to make the choices she made, and it was our place to love her, support her and keep her comfortable.

Caregiving has many challenges and most of them are difficult ones. Sharing experiences among those of us who become caregivers is supportive and emotionally necessary. A good resource we recently discovered is UnitedHealthCare’s Solutions for Caregivers service. This is only one of many available on the Internet. Just enter ‘caregiving’ in your search box, and a gazillion helpful resources will be available to you.

It seems that seniors are always on the lookout for ways to save money. That is likely because most of us live on a fixed income that is based on a Social Security check and -for some- a pension. We don’t like to dip into our investments, if we have any, because that represents the ‘rainy day’ money that helps us feel more financially secure.

When a couple of events occurred in the past few weeks, we took note and decided to share our experiences with our readers.

The utility company sent us a notice that said our monthly electric bill had been reduced by 60%. Wow! We are on the plan that estimates our usage over a year, averages that usage and bills us the same amount every month. A reconciliation takes place every year, and the account is analyzed quarterly to be sure we are actually close to the estimated amount.

We accumulated more than $800 excess payments in six months, and our monthly bill was reduced as a result. How did this happen? Likely, part of the excess was the electric company over-estimating our bill. But it is based on average temperatures, square footage in our home and guesses about how much electricity we will actually use.

What did we do? We do not use the electric clothes dryer; we hang our clothes on two small drying racks outside on the patio. We set our thermostats at 80´(summer) and 78´winter, and dress accordingly. We make sure the furnace/AC is turned off when we do not need it; we open doors and windows front and back to get a breeze through the house in the early morning. Lights are turned off when we leave a room. We seldom use the electric oven in the kitchen; instead we use our patio grille for baking and grilling. We heat water with an electric tea kettle rather than using the cooktop. We turn off electronic items when not in use.

More Tips for Saving Money

The other thing we do to save money is drop our coins in a jar every few days. My purse gets heavy with the accumulation of coins, so years ago we began saving coins and taking them to the bank a couple of times a year. There are all kind of options for what to do with the saved money. We’ve used it for gifts for our adult children; mad money for us; a special treat that we would not otherwise purchase; savings; travel… the options are boundless. The money we saved this time will go for a special trip we are taking to celebrate my 70th birthday.

Money saving tips are numerous on the Internet. This one on the AARP website helps seniors think about what they can do to not only save money, but also add to their income. It is literally possible to add thousands of dollars to your annual income with these suggestions. Take a look and then decide which ones will work for you.

Toxic chemicals have no place in the homes of senior citizens. We rely on public information to tell us when a product has ingredients that are harmful. And sometimes that information is clouded by special interests of companies that want us to buy their products in spite of the poison in them. So we have to perform due diligence and find the best information available before we decide what to purchase.

Following are some resources SCJ found that other seniors might find helpful:

• Triclosan: This chemical has long been found in cosmetics and soap used on the body (including shampoo). The Suzuki Foundation has labeled it toxic for years. Triclosan has been in the news lately (2013) because the FDA recently put a spotlight on the potential links to hormonal issues.
• Other “Dirty Dozen” chemicals identified by the Suzuki group include BHA and BHT, coal tar dyes, DEA, cocamide DEA and lauramide DEA, Dibutyl phthalate, formaldehyde-releasing preservatives, parabens, parfum, PEGs, petrolatum, siloxanes, and sodium laureth sulfate. You can read about all these dangerous chemicals in this PDF document on the David Suzuki site.
• Those plastic flea collars for pets (dogs and cats) contain pesticides. And although the collars repel fleas, the pesticides are also dangerous for your cat and dogs. There are many non-toxic products available, including sprays and a variety of other kinds of repellants.
• Many ‘weed and feed’ products for lawns contain a herbicide called 2,4-D. Although research on this chemical is scarce, there are enough anecdotal reports of health issues that we are well-advised to stop using it. What to do instead? Pull weeds by hand, or better yet, spread small rocks/stones on your ‘lawn’ for total weed control.
• Cleaning products all contain chemicals that are harmful if ingested. This means not only if we get them in our mouth/eyes/ears, but also if we come into contact with them on our hands or body. Remember, our skin is the largest organ in our body, and whatever we put on our skin gets absorbed into our body in just a few seconds.

There are other chemicals that have the potential to be dangerous to our health. Read the labels and if you find something you don’t understand, go to your computer and do a search on it. There will be an abundance of information that you will find helpful.

There’s nothing that can reveal the vastness of the great American landscape better than a road trip. Seeing the geography and history firsthand is better education than any classroom. The thing is there’s a lot of country out there, and it would take months to see it all at once.

Choose the locations you would like to visit first — focus on a region, a landmark or simply traverse the rich diversity one mountain road at a time.

Retracing the Steps of the Pioneers

The Appalachian Mountains were the first large obstacle to many American settlers. Upon finding much of the coastal area settled even before the American Revolution, later colonists set out in search of land and fortune in this rugged landscape. As you drive through the mountain ranges, which stretches from Georgia all the way into Quebec, you will not only witness the beauty of the Great Smoky Mountains and numerous Civil War battlefields, you’ll see quirky roadside attractions like the World’s Largest Chest of Drawers in High Point, NC, states roadsideamerica.com, natural wonders like the Luray Caverns and Shenandoah National Park in VA and the Cass Scenic Railroad State Park, in Cass, WV, according to cassrailroad.com.

Photo of the Appalachian Mountains by Nicholas_T via Flickr

South Texas Birding Nature Adventures

Southern Texas is home to the World Birding Center’s nine unique locations along a 120-mile historic river road south of Corpus Christi, according to theworldbirdingcenter.com. Visitors to any one of these sites can take in not only the scenery of the Rio Grande Valley, but a unique birding adventure. Those who take this opportunity will witness one of the most incredible migrations on the planet. The trip can be the start to a tour of the entire Rio Grande Valley, from Padre Island on the Gulf to Big Bend National Park and on to the city of El Paso.

Photo of Big Bend National Park by R Hensley via Flickr

Route 66

Traveling west from Chicago, the iconic Route 66 cuts through cities such as St. Louis, Oklahoma City, Amarillo, Albuquerque and Flagstaff before it finds its terminus in Los Angeles, according to historic66.com. Drivers will experience more than just the sights and sounds of these great cities, they’ll also get the chance to see the bucolic landscape of the Great Plains, the rugged mountain ranges of New Mexico, the Sonora Desert and eventually, the majestic waters of the Pacific.

Photo of a Route 66 sign by eGuide Travel via Flickr

Before You Go

Before any type of trip, there are certain steps you must take.

• Stop by a trusted service center before you leave. Hyundai Scottsdale recommends having a factory-trained professional change your oil, fill fluids, balance and rotate tires, check brakes and under the hood.
• Create an itemized list of everything you need while on the road. This list should include not only a spare and tools to change a tire, but also a small gas can, flashlight, batteries, first-aid kit, GPS, maps, audio books, music, non-perishable snacks and plenty of water.

Research the destinations that peak your interest. This includes cities, towns, historical sites and national or state parks. In some cases, these locations may be undergoing renovations so be sure to check hours of operation and summer hours.

Someone recently said to me, “I do not want to die with any regrets.” My life-long statement to self has been, “I want to be proud of what I do and say.” This was certainly true of the six months we spent caregiving. Did I live up to that totally? No. Did I get close? Yes. I learned that, because there is life after caregiving, I needed to conduct myself so I would not end up with regrets.

By far the most difficult situations we encountered caregiving for my mother-in-law centered around her safety. Momma never got her fair share of common sense and good judgment in life. Health care professionals, particularly in rehab after she broke her hip for the third time, consistently identified her lack of judgment as a major problem in her rehabilitation. So we came to her last days still trying to manage her safety in the face of her poor judgment.

In particular, Momma insisted on doing what she thought she could do, what she wanted to do, in the face of the Hospice team telling her she wasn’t safe doing that. And there wasn’t any amount of cajoling or reasoning that worked to convince her otherwise. In the first three months, she fell/slid to the floor about every other day. We kept putting safety precautions in her environment to minimize her falling, but she still would ‘walk the furniture’ around the room and refuse to use her walker or wheel chair.

Caregivers Face Tough Decisions

There came a point when I had a discussion with Hospice professionals about how far we should push the insistence that she stay safe. That conversation included references to the legal responsibility we had for her safety, and the potential consequences if we weren’t protecting her appropriately. When I learned we could be charged with ‘endangerment’, the decision to insist on her safety was an easy one. I’m willing to be her caregiver; I’m just not willing to face going to jail because she didn’t use good judgment.

From that point on, the tension increased over what she was no longer allowed to do, and we learned to manage the daily incidences with as much grace and understanding as possible. Some days were better than others. I grew eyes in the back of my head. We moved her hospital bed out into the great room so we could watch her more easily without obviously checking up on her. We had to say “No” more often than we wanted, and we always referenced her safety. We had to recognize that was the best we were going to do.

My only regret is her inability to understand the need for the many safety precautions we had to create. And I recognize I had no control over her ability to understand. I have absolutely no regrets that in the six months of care, although she fell many times, she did not break any bones nor suffer any major contusions on her body. I know that is because we insisted she be safe.

If you are the last of your family, as all the other significant members have passed on, an empty hole, hard, if not impossible, to fill, seems to characterize your emotional state. At 74, and an only child, losing my parents has meant that that mysterious connectedness which has been with me all my life is now in the past.   You are now quite alone.  Although you likely have created other significant alliances that have helped you get through life, those most intimate and emotionally significant to you are now gone.

Those who have enjoyed and celebrated having siblings or geographically close relatives of one ilk or another have the memorable joy of some important unions.  Some find the fraternity of long time friends to be helpful in cementing significant relationships.  There is, for most of us, the need to cultivate those ties that give us some sense of significant connections in our lives.

Along the way our childhood friends fade as we move up and move on into other phases of life’s journey.  Even those with whom we find ourselves bound during school days, college and early adult life, disappear as the demands of just living and being take over.

Trying to find ways to stay in touch becomes more and more of an easily dropped practice.

Obituaries increase in number and among those listed are many who are remembered fondly.

Reaching out periodically for one last “hale and farewell” is often a vain attempt that brings the news that one more colleague has left this mortal earth.

The cold breezes of death that blow ever increasingly as daily life takes on so much change, so many reminders that our own lives are so temporary and those who have helped it to be what it is like us are fading away.

Coping Brings Celebrations

When we are the last one’s left, or about so, it is fitting that we find ways to bind hearts and souls together in a genuinely meaningful celebration of that which still means so much.  It is also an exercise in recognizing just how many of the saints, who may be just hanging on, to affirm how precious they yet are to us.

Sharing in the warm greetings with those who were thoughtful to drop by at the Visitation, gazing out over the crowd who gathered at the grave side stirred the most sincere feelings of long term genuinely regarded affection that has covered a  life time. These were among the rewards of Mom’s 94 years and an accumulation of those many endearing loved ones who loved and respected her so much.

For those of us who remain, we will now rely on memory, stirrings of long held and precious recollections that will pull at our heart strings.  Momma, you are missed, you are held in deep and lasting ways that only time can resurrect.  Our bond is secure.  Life’s deepest meanings are now the means by which we are so firmly and lastingly held together.  Those who have experienced the last farewell, who hold on to the fondness of life’s purest and deepest known love are aware of the disconnect, the pain, the hole, the separation that now is so real.

So it must be.  And so will it ever be from this day on.  On the darkest nights, during those tear filled days, as memories prompt, as pain edges its way into our thoughts our lives will be brushed with hurt, with sadness, with an alienation that seeks some form of fulfillment.

Momma, help us to cope, to struggle with being the last one left.  Help us know you are the love of life that will visit us when we need you most.

One of the benefits of being a senior citizen these days is the joy of admitting we have a lot yet to learn. We don’t have to prove ourselves any longer. We can just be ourselves, open to learning whatever new behaviors and insights happen to come along our way.

Such is the case with our most recent caregiving experience. It was actually the first time we had taken on the responsibility of care for another human being. I had always insisted I wasn’t a nurse and didn’t want to be one. But when faced with the choice of caring for my 93 year old mother-in-law in our home, I didn’t hesitate. She had been a loving and caring person all her life; it was time for that love and care to be returned to her in her last days.

Caregiving lasted just six months and a few days. She suffered from generalized debility, first losing one self-help skill, then another. Jerry deferred most of the personal care assistance to me; it just wasn’t his thing.

So I took on the task and never looked back. She died just three weeks ago, and already I’m identifying many things I learned about myself and caregiving.

The list is much too long to include in just one article, so this will be a series. And I hope our readers will enjoy sharing our experiences and perhaps even learning from them as well.

Caregiving Changes Your Life

I learned early on that caregiving is a life-changer. Yep. Our daily lives changed dramatically, and we will be on a different road forever.

Caregiving requires a level of self-denial that I hadn’t experienced previously. My day was dictated by what Momma wanted or needed or required. Hospice entered the scene early on when it was clear to me that I could not take care of her by myself. I was determined not to put her back in a nursing home, so the alternative was to bring home-health care into our home. She qualified for Hospice immediately, and their services were invaluable over the six months of care.

Momma’s wants and needs were pretty simple for the most part. I helped her dress with clothes she chose for the most part. Her daily (sometimes twice daily) desire for ice cream meant I had to have it on hand all the time. Her personal aide bathed her twice a week, and I took care of keeping her clean the other days.

I discovered that my own personal care suffered as a result of the time I spent on Momma. There just wasn’t enough time in the day for me to take care of both of us, so I took care of her first. If there was time left over, I managed to do what I needed to do for myself.

This changed my life because I realized I can live just fine with a shampoo two or three times a week, rather than daily. If I don’t shower every day, the world does not come to an end. My face looks good without makeup. Manicures and pedicures are no longer mandatory. My short, cropped hairstyle that requires no comb or brush is a good one for me.

Life-changing. Indeed. I’ll likely never return to those previous expectations.

Next: Stages of Caregiving

What you decide to do for compensation after you retire will depend on what emerges when you inventory all of your interests and skills. Unlike times in your career when you may have taken a job you didn’t prefer because you felt you had to, you can take the time in post-retirement to find something that’s an ideal fit.

Let’s Examine the Possibilities

If you happen to have training as a nurse and you find yourself with wanderlust, travel nursing could offer a perfect future for you. A travel nurse is hired to work for a limited amount of time (typically up to 13 weeks) in a specified location. The salary for travel nursing can be as high as $75,000 yearly.

If wellness interests you and you don’t mind completing some additional education, you’ll be able to consider several possible part-time jobs. How about a skin care specialist or a nutritionist? Or, think about working as a licensed massage therapist. That’s a job that can help you stay in shape.

Opportunities for Skin Care Specialists

There are many settings where skin care specialists will be needed in the years ahead. Thanks to baby boomers having plenty of disposable income along with concerns about aging, jobs for skin care specialists are expected to increase by 25 percent between now and 2020, the Bureau of Labor Statistics reported. Department stores will need sales clerks to help customers choose purchases — in addition to demonstrating proper use of skin care products. Spas, health clubs, and beauty salons are also hiring skin specialists to recommend products and if trained properly, to perform some skin care procedures, such as waxing or facials. Skin specialists can earn more than $24 hourly.

Opportunities for Nutritionists and Dieticians

Opportunities for nutritionists and dieticians are expected to jump by 20 percent in the next seven years, the BLS reported. Though the two terms are often used interchangeably by mistake, a nutritionist can be anyone who is knowledgeable about human nutrition; a registered dietician requires specific college training. Corporations with wellness programs, health clubs and private or charter schools likely will want to hire nutritionists. Supermarkets and restaurants often hire nutrition experts to create special menus. Nutritionists can expect to earn about $18 hourly.

Opportunities for Massage Therapy

A licensed massage therapist must receive certified training, but demand for these professionals is expected to soar through 2020 and opportunities will abound in spas, fitness clubs, resorts and hotels and retirement communities. Expect to earn close to $17 hourly, but with tips, you’ll probably earn more.

By discovering the perfect next “mini career,” you’ll be guaranteeing yourself the most rewarding retirement possible — one that offers freedom and fulfillment.

Photo by Flickr user 401(K) 2013

I remember when I was attacking the long and tedious process of research and writing for my doctoral dissertation. I mostly remember the pain and agony of attention to detail. But I also remember my advisers telling me that what I studied had to be transparent, and it had to be verifiable by other researchers. Those are just basic tenets of sound study.

Scientific research and study must be inherently unbiased. That is, you start out with a premise and then your data either supports that premise or it doesn’t. Any attempt to manipulate the data to a preconceived conclusion renders the study invalid.

That’s what happened recently when a 28 year old graduate student tried to replicate the Reinhart-Rogoff (2010) study on austerity. He discovered the data is faulty. There are now additional economists who support the faulty data claim.

Tainted Data in a Dirty Study

Progressive journalists fault the Petersen Institute for International Economics who bankrolled the Reinhardt-Rogoff study. They claim the original study was an attempt to provide a basis for right-wing efforts to cut spending and stall the economy into a crisis from which wealthy Americans would eventually prosper.

The only problem is they got caught.

As Progressive Thom Hartmann says, “It’s time for President Obama and Democratic leaders to see the writing on the wall and take a formal stand against austerity.  No nation, in the history of the world, has ever cut it’s way to prosperity, and no fabricated economic study can change that.” (www.thomhartmann.com)

Senior citizens are met with the need to discard medications safely for a variety of reasons. Sometimes we need to throw out leftover meds because we no longer take them and/or they have expired. Or we may need to toss them because they no longer are doing the job, and between us and our primary care physician, we have determined to stop using them.

With the loss of our mother a couple of weeks ago, we were faced with having to discard medications she had been using, and in particular to safely dispose of morphine, a controlled substance, and ativan, a Schedule IV controlled substance. Her physician had prescribed these meds for her comfort in her last days. And we had some left over.

The Hospice team assigned to our family was very helpful when it came to deciding how to safely dispose of these meds. They were in liquid form and we scattered some baking flour on a plastic sheet, then poured the fluid medication on the flour and mixed it all up. We then put the mixture and plastic sheet in a plastic baggie and closed it before tossing it in the trash. Used coffee grounds work as well a flour to absorb the fluid.

Helpful Resources Online

We also had leftover medications in pill form and not controlled substances. We did a search on our favorite search engine to find some help. The phrase we entered was ‘dispose of medications safely’. SmarxtDisposal.net popped up and we consulted the site for advice about tossing the pills.

The first step is to put the pills into a container that you do not need/want to keep. Add water and mix up the pills in the water, dissolving them all. Then you can close the container or put it in a baggie that you can zip closed. Dispose of the mixture in your trash can.

National Take-Back Initiative Day is April 27. If your community is participating in this event, you can take pills to a designated location for safe disposal. Check your local newspaper or search online for the most convenient drop off spot.