Senior Resource Guide (Fall 2022) by Senior Resource Guide for the Modern Caregiver

SENIOR

RESOURCE guide your

DEMENTIA DIAGNOSIS

The 3 steps to take immediately after

HAVING THE CONVERSATION

When dad disagrees on mom’s care

ULTIMATE GUIDE TO

aging care

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EXPERIENCE THE NOT-FOR-PROFIT DIFFERENCE Not-for-profit providers of aging services offer a commitment to quality that stems from a mission of service and a history of compassion

LOCATE PROVIDERS IN YOUR AREA

HIRING ALL OVER THE STATE

leadingagetexas.org/directory

careers.leadingagetexas.org/jobseekers

LeadingAge Texas is a trade association representing the full continuum of missiondriven, not-for-profit aging services providers. Providers can learn more & apply for membership at www.leadingagetexas.org/memberships

info@leadingagetexas.org

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(512) 467-2242

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the

CAREGIVING journey Rosalynn Carter says there are only four kinds of people in the world:

• Those who have been caregivers

• Those who are currently caregivers • Those who will be caregivers • Those who will need caregivers

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aregiving has a way of creeping up on us. As family, friends and neighbors, we all want to be there for our loved ones when they need us. Very few of us see ourselves as a “caregiver,” and most of the time we haven’t had any training on how to be a caregiver, or an understanding of the depth the role requires. For the majority, it takes a “trigger event” such as a fall, hospital admittance or diagnosis of a health condition before there’s full realization of the situation and what plans/actions need to take place. The Senior Resource Guide is designed and geared towards the unique needs of the modern caregiver. We’re here to help take the guesswork out of this challenging role by providing support and knowledge-based information at your fingertips when you need it—both in print and online. As you journey through different stages in your caregiving quest, our hope is that you’ll be able to use the Guide to help create space for flexibility and make well-informed decisions. At the end of the day, feeling good about your care and efforts, as well as seeing your caregiving experience as a positive expansion and transformation, will help you and your loved one live more fully. In the words of our Founder, here’s to your quest!

TRANSITION AND REFLECTION “What do I do now that they’re no longer here? How can I honor my journey? How have I grown?”

LATE PHASE FINDING BALANCE “I’m needing to recharge but there’s not enough time.”

• 5 Vital Tips to Help Deal with Caregiver Stress (see pg. 82)

FINAL PLANNING “How do I make sure they’re taken care of and their wishes are met?”

• Understanding Hospice (see pg. 114)

SHIFTING PRIORITIES “I know this is what’s going on and need to give it attention.”

INCREASING DEMANDS “This is getting bigger and needs more of my attention.”

MAJOR TRIGGER EVENTS “What are our next steps now that this event has happened?”

• Questions to Ask During Hospital Discharge (see pg. 102)

• Home Care versus Home Health Care (see pg. 70)

IDENTIFYING YOUR ROLE “I’m needed to help out.”

• Caregiving Expectations (see pg. 14)

MID PHASE

PLANNING AND PREPARING

• Signs Not to Ignore: Dementia versus Normal Aging (see pg. 96)

EARLY PHASE

• Getting Connected with Help (see pg. 26) • 5 Must-Have Legal Documents (see pg. 52)

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DETECTING CHANGES “Is this part of normal aging?”

“This is not normal aging, what is it and what can I do?”

CONTENTS \\

GENERAL INFO \\ 4

The Caregiving Journey

Our Legacy

The Senior Resource Guide Team

EARLY PHASE \\

THE ROLE

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Caregiving Expectations

THE PLAN

Creating a Care Plan

20 Overcoming Guilt with Senior Care Decisions

30 What Level of Care is Right

Navigating Family Conflicts

Finding Time Away from Your Care Role

Why it’s Essential to Research Senior Living Facilities

Spectrum Retirement Communities (see also back cover)

What to do When Your Parents Need Different Levels of Care

Get Connected

40 What’s an Adult Day Center? 42

Ombudsmen are Here to Help

CONVERSATIONS

Having the Conversation: When Dad Disagrees on Mom’s Care How to Talk with Your Parents About Their End-of-Life Wishes

How to Talk with Your Siblings About Caregiver Responsibilities

LEGAL + FINANCIAL

Five Must-Have Legal Documents

Paying for Long-Term Care

INITIAL MEDICAL CARE

Understanding Medicare: Parts, Plans and Meeting Your Needs

A Guide to Medication Obstacles

Mobile Care

When Do You Need to Consider In-Home Care?

How to Handle Resistance to Bathing, Eating & Medications

Home Care versus Home Health Care

CarePatrol (see also pg. 3)

Theft Accusations from a Senior: Real or Not

DAILY CARE

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MID PHASE \\

CONTENTS \\

MID PHASE \\

SELF CARE

5-Minute Comfort: Adaptogenic Hot Chocolate Recipe

80 Meaningful Minutes for Caregivers 82

Five Vital Tips to Help Deal with Caregiver Stress

MEMORY + DEMENTIA

90 Getting a Dementia Diagnosis

Tips for Effective Alzheimer’s Communication

Changes in a Senior’s Appetite: What’s Normal?

Signs Not to Ignore: Dementia versus Normal Aging

Special Diet-Friendly Soup Recipe

100

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DIET + WELLNESS

NEW STEPS

100 Care Transitions 102 Questions to Ask During Hospital Discharge

104

107 Senior Living Communities

104 Types of Residential Care for Seniors

109 Franklin Park Senior Living (see also pg. 1)

SENIOR LIVING

110 Questions to Ask When Looking for an Assisted Living Facility 112 Questions to Ask When Considering Skilled Care

LATE PHASE \\ 114 Understanding Hospice

122 Steps to Take After the Passing of a Loved One

119 OpusCare of Texas (see also inside front cover)

124 Preparing & Presenting a Eulogy 126 7 Items to Consider When Planning a Celebration of Life

See you online srgtexas.com

Visit srgtexas.com to enhance your caregiving journey even further. Access this edition’s extended content + additional helpful articles, local caregiver events, support groups, and our online directory of senior care services in your area.

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120 Questions to Ask When Choosing a Hospice Program

Cora Hobbs 1915-2006

Our

Karyn Dean 1957-2020

LEGACY

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hat began as a simple collection of local resources has blossomed into what we now know as the ultimate guide to aging care. As a caregiver for her grandmother and an eldercare advocate for over 25 years, our Founder Karyn Dean realized she was not alone in the quest for information and resources. It was her dream to create a reliable resource that caregivers, seniors and eldercare professionals could turn to when navigating the many challenges associated with aging—thus was born the Senior Resource Guide. Although Karyn is no longer with us, her dedicated mission of educating family caregivers and senior care professionals as well as her memory lives on. Her beautiful spirit guides every thought and decision throughout our transition into the modern caregiver’s resource. What started out as a passion project with her husband quickly grew into something more when their children united behind the mission and joined SRG. Today, a team of compassionate individuals are part of the SRG family and bring an enthusiastic energy to helping caregivers through their journey.

P U B L I S H ER The Dean Family

CO N T R I BU TO RS Franklin Park, John B. Earthman, Mayo Clinic, Sharon Wagner, Texas Health and Human Services, The American Elder Care Research Organization

A RT D I R ECT I O N /G RA P H I C P RO D U CT I O N Erin Suwwan, Jaclyn Threadgill – LuckyYou! Creative

SA L E S Alex Dean – Director of Business Development Morgan Keefe – Campaign Success Manager Jason Rodriguez – Account Executive

MARKETING Jennifer Stavert – Director of Marketing Winona Vo – Senior Marketing Executive

D I ST R I BU T I O N Brian Stavert – Manager Myles Moore – Senior Distribution Executive

C H I E F E X EC U T I V E O F F I C E R Terry Dean

FO U N D E R & C H I E F V I S I O N A RY A M O N G T H E A N G E LS ©2022. Senior Resource Guide is published semi-annually for the Greater Houston, Austin & San Antonio markets by: SRG Services, Inc., 77 Sugar Creek Center Boulevard, Suite 600, Sugar Land, Texas 77478 \\ 281–277–2333 \\ SRGTEXAS.com Disclaimer of Endorsement: Reference herein to any specific products, process, or service by trade name, trademark, manufacturer, or otherwise, does not necessarily constitute or imply its endorsement, recommendation, or favoring by the Senior Resource Guide.® The views and opinions of authors herein do not necessarily state or reflect those of Senior Resource Guide® and shall not be used for advertising or product endorsement purposes.

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Karyn Dean

EARLY PHASE \\ THE ROLE

CAREGIVING EXPECTATIONS Preparing for the Position

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t’s not always easy watching a loved one age. This can become especially hard when they reach the point of no longer being able to take care of themselves. And, if you didn’t already find yourself providing some level of assistance before a major life event occurs, you may now find yourself in the role of being the caregiver. You may have intentionally elected to become a professional caregiver or a caregiving volunteer to help those in need. In any case, if you’re new to this journey, here are some helpful tips to keep you prepared as you embark on this path.

THE ROLE OF CAREGIVER This is a role you can find yourself in rather quickly without knowing it happened. A serious health event is typically the catalyst for this type of situation. However, this change can also happen gradually, and the role of caregiver might be taken on without even realizing it until you're deep into the process. For instance, you may initially stop by just to check on your loved one. Gradually, the number of visits increase, and

progressively those visits turn into helping prepare meals, assisting with lawn maintenance, light housekeeping, and managing medical appointments. Before you know it, they’re heavily relying on you and unable to do many of these things themselves. Whether you had a conversation about it or not, at a certain point you realize you’ve accepted and taken on the role of caregiver. Although you're now taking on the responsibility to care for someone else, you may already have quite a lot of responsibilities of your own (perhaps children or a full-time job). It’s important to know and understand the responsibilities that come with your new caregiver role. This way, you're better able to care for them with confidence, empathy, preparedness and love throughout this journey.

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Your caregiver quest doesn't come with a manual, so here are some examples of tasks you can anticipate in your new role: • Help with finances such as paying bills, credit cards,

managing rent and utilities or home care fees • Buy groceries, clothes and toiletries • Arrange medical appointments and provide transportation to and from • Be a companion or arrange for companion care • Help cook and clean • Assist with pet care • Ensure legal documents such as wills, trusts, guardianships, power of attorney are addressed • Keep other family members apprised • Make hard medical decisions

PREPARING FOR THE ROLE It can be easy to become overwhelmed and stressed when taking on this role for the first time. Here are some tips that can help you and the person you’re caring for feel more at ease. HAVE A CONVERSATION about you becoming their official caregiver and establish responsibilities and boundaries

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BE SURE to have all physicians’ information on hand and establish yourself as the primary caregiver for the person. You may need to have them sign paperwork allowing you to see their health information under HIPAA or have a medical power of attorney document MAKE A LIST of all medications they’re taking as well as allergies and hospitalizations in the last 10 years

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EARLY PHASE \\ THE ROLE

SPEAK to them about how their financial obligations will be resolved TALK about where they want to live out their remaining years ASK if possible to be added to their bank account, which will allow you to easily pay bills BE SURE to determine whether they have a power of attorney or other legalities in place FIND SUPPORT for both yourself and your loved one as neither of you are alone in this process CREATE a catalog of experts that you’ve interacted with. You never know whose expertise you might rely on in the future

SETTING EXPECTATIONS e op C to s y a W • Taking care of yourself

• Seeking mental health assistance when needed • Getting enough sleep

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• Building a strong support system • Drinking plenty of water • Exercising • Eating clean

It’s important to take care of yourself. Being a caregiver can easily take over your life if you’re not mindful. While you want to be there for your senior loved one, you also need to be there for yourself. When you’re struggling, seek help. When you’re unable to do something, it’s okay to say no. When you take care of your mental and physical self, you’re better able to care for your loved one. We are here with additional resources as needed. Remember, you are not alone as it takes a great deal of strength to be a caregiver.

CREATE A LASTING LEGACY WITH US “What you leave behind is not what is engraved in stone monuments, but what is woven into the lives of others.” Pericles

EVERY MAN, WOMAN, AND CHILD DESERVES AN OPPORTUNITY FOR A GOOD LIFE. By making a gift to United Way’s Endowment and Legacy Fund, you can honor a loved one, perpetuate your family name long beyond your lifetime, and ensure the programs and services to children, individuals and families continue into the future. The enduring nature of your vision and generosity will continue to serve San Antonio and Bexar County for many years to come.

United Way of San Antonio and Bexar County

700 S. Alamo St. | San Antonio, Texas 78205 | 210.352.7000 www.unitedwaysatx.org

EARLY PHASE \\ THE ROLE

OVERCOMING GUILT WITH SENIOR CARE DECISIONS

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f you’re responsible for deciding care for your elder family member or friend, it can cause a lot of stress. Senior care decisions aren’t easy for anyone to make, especially for a loved one. Are you making the right choice by putting them in a senior living community or personal care home? Will they receive adequate care? Are you capable of being their caregiver? Do they need more care than you can provide? If things go wrong, is it your fault? What could you have done to prevent this scenario altogether? These are all questions you’re probably asking yourself, and you’re not alone—many caregivers feel this guilt, and there is support out there for you. Caregiving can sometimes feel like a demanding, full-time job. Although it allows you to spend more time with your loved ones, it can be quite emotionally and physically draining. One of the most challenging decisions to make is whether or not to seek other care options. These options vary by level, ranging from no assistance to around-the-clock nursing care. The answer as to whether you should pursue senior care options for your loved one is never black and white, often resulting in mixed emotions. Recognizing the feeling of guilt is the first step in tackling those difficult emotions that often accompany eldercare. Ample research and communication play a key role in alleviating guilt and making the best decision for your loved one. It’s important that guilt is addressed as it’s unlikely to go away on its own. Trying some of the following tactics may help in reducing guilt.

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• Openly discussing the situation

ou Y l e e F e W

If you continue to beat yourself up for not being able to provide all the care they require, seek forgiveness within yourself. Recognize that you’re doing your best to help your loved one and you still play a valuable role in their care. Guilt can affect your relationship with your loved one and the attention and care you’re able to provide. If you’re struggling to find ways to work through guilt, a therapist, counselor, or support group are additional options to help untangle emotions and find ways to create change within yourself. Prioritizing mental health is vital for both your well-being and your ability to provide the best care for your loved one.

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with your loved one, friends and family can help ease some Sometimes guilt can burdens while also ensuring become so strong everyone feels confident about it’s difficult to get any choices made. through each day. • Researching the right care and involving your loved one in the process as much as possible can help alleviate feelings of guilt. • Mentally opening the door to let guilt, frustration or regret come in is sometimes needed to address and process the complexity of these emotions. Writing down what you feel or simply observing these feelings without judgment can make them less powerful and lighter. • Identifying the source and recognizing where it is coming from is the key to navigating feelings of guilt. • Practicing gratitude and shifting your focus to acknowledging any opportunities you’ve gained as a result of your decision about their care. For example, are you able to spend more quality time with your loved one now? What are you more knowledgeable about now having gone through the situation? • Consider what you might say to a friend or family member in a similar situation as you. Oftentimes, we’re harder on ourselves. Show yourself some kindness and replace those negative self-thoughts with compassion.

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While Caring for Aging Parents

roviding care for aging parents can be an emotional and challenging experience. When siblings, spouses or other family members get involved, it can become even more complicated. As conversations escalate over how to best care for your parents, it’s essential to remind yourself, no matter what, each of you has their best interests at heart.

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CALL A FAMILY MEETING A family meeting is one of the most effective ways for multiple family members to communicate. Proactive discussion can be beneficial as the family has ample time to research and come to a decision everyone is comfortable with. The point of the gathering is to outline various care options and define each family member’s specific role and responsibility. BRING IN A THIRD PARTY When an agreement as a family seems difficult, consider hiring a professional counselor or family therapist who specializes in these situations. It can also mitigate strain or tension among siblings.

8/7/19 3:12 PM

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PUT YOUR PARENTS’ NEEDS BEFORE YOUR OWN When navigating care options for your parents, it’s essential to separate your parents’ needs from your own. Set aside sibling differences and come together as a cohesive family unit to do what’s best for your parents. Ultimately, by ensuring your parents are safe, happy and properly taken care of, this can ease tension among family members.

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REEXAMINE FAMILY ROLES Labels placed on you when you were children, such as “troublemaker, bossy or caring,” can last through to adulthood and can become especially problematic when discussing care for your aging parents. Adult children need to set aside any childhood roles and labels they may have been given and come together to help the family unit.

EARLY PHASE \\ THE ROLE

FINDING TIME AWAY FROM YOUR CARE ROLE

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ven though you have a loved one you care for dayin and day-out, it’s likely you have other duties and responsibilities outside of providing for your elderly or disabled loved one. This overflow of obligations is a classic recipe for exhaustion and shattered nerves, especially when you tack on the emotional burden of these obligations being something you care deeply about. Many caregivers experience burnout simply because they cherish (and stress over) the well-being of loved ones so much. When you’re burnt out, you’re not able to provide the same amount of attention and care because, in most cases, you’re completely drained mentally and physically; your glass is empty. And an empty glass has no way of quenching the thirst of those in need. That’s why it’s so important for caregivers to fill their own glass first with self-care and a respite plan.

WHAT IS RESPITE? Respite care is a way for those experiencing caregiver burnout to rest and recharge. There are many services to utilize in Texas. Essentially, caregivers always have to be on guard and ready to respond when needed, preventing you from turning off completely. Respite care gives you consecutive time off ensuring you can completely switch out of working mode for hours or

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It’s so important for caregivers to fill their own glass first with self-care and a respite plan.

WHY IT’S ESPECIALLY NEEDED FOR DEMENTIA CAREGIVERS Additionally, caring for someone with dementia, memory issues or Alzheimer’s can feel overwhelming. On top of scheduling and keeping track of things for your loved one’s life, you have to remember everything for your own day-to-day, which can be challenging. Studies show that informal and familial caregiving shares strikingly similar characteristics with chronic stress. Both informal caregiving and chronic stress eat at you over a long period of time, having psychological and physical effects that may seem subtle to those not aware. Other areas of life, such as relationships, hobbies or work, are also strained in response. This stress accumulates and may simply turn into your lifestyle. Since taking care of a loved one usually goes unpaid, some providers forget that what they’re doing is actually work. And just like your average 9-5 job, you need to take time away from that work to make it sustainable. As a caregiver, be on the lookout for mental and physical signs of stress and exhaustion, and when spotted, realize it’s time to look into care facilities or in-home respite care in Texas.

Dive Deeper

Discover different kinds of respite care available in Texas as well as typical costs in the full article, visit srgtexas.com/caregivertoolkit

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days at a time. These services provide a professional caregiver or facility to take your place so that you can completely unplug from your duties.

Don’t get Burnt Out

EARLY PHASE \\ THE ROLE

GET CONNECTED Familiarizing Yourself with Local Resources That Can Help

TEXAS HEALTH AND HUMAN SERVICES The agency offers a wealth of information to connect you to resources, health care providers and services that can help you and your aging loved one live healthier. In the menu bar on their website is a dropdown for “Services,” which provides a wide range of helpful resources for people with medical, physical, intellectual or developmental disabilities; older adults; and caregivers who need a break from their duties. If you’re unsure how they can help, or even if you may not qualify for a program or service, Texas Health and Human Services’ trained professionals can help steer you in the right direction.

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Call 1-855-937-2372 or visit hhs.texas.gov

2-1-1 TEXAS As a trusted state resource available for free 24/7, 211 Texas is a connector for all Texans to critical, community-based services. Whether it’s a sudden medical bill, a natural disaster, a veteran trying to return to civilian life, or a concern about an aging parent—people from all walks of life can find themselves in need of assistance and confronted with a maze of agencies and programs that are challenging to navigate. Their trained helpline specialists are good listeners, blending understanding and expertise to provide information and referrals drawn from a comprehensive database of social services. Call 2-1-1 or visit 211texas.org

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UNITED WAY FOR GREATER AUSTIN United Way seeks to ensure that all older adults can live vibrant lives. They offer resources to a number of programs that focus on older adults’ health, financial security and engagement. Visit unitedwayaustin.org/connectatx for a searchable directory that offers information on several community programs covering an array of categories including transportation, housing options, benefits screenings, meal options and elder abuse.

An Overlooked Resource

UNITED WAY OF SAN ANTONIO AND BEXAR COUNTY Call 210-352-7000 or visit uwsatx.org

Support groups are an excellent resource and there are many specifically for caregivers. See srgtexas.com to find support groups in your area.

AREA AGENCY ON AGING Serving over 250,000 people annually, Texas’ 28 area agencies on aging offer help to Texans age 60 and older, their family members and caregivers to locate and access local services, including benefits counseling, legal assistance, care coordination, caregiver support services, in-home support and the ombudsman program.

Area Agency on Aging of the Capital Area Call 512-916-6062 or visit aaacap.org Alamo Area Agency on Aging Call 210-362-5212 or visit aacog.com/65/Alamo-Area-Agency-on-Aging Bexar Area Agency on Aging Call 210-477-3275 or visit aacog.com/108/Bexar-Area-Agency-on-Aging

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Area Agency on Aging of Central Texas Call 254-770-2344 or visit aaact.org

EARLY PHASE \\ THE PLAN

CREATING A CARE PLAN

ith more Americans living well beyond their 70s, many individuals are now finding themselves entrusted with the position of caring for their aging parents, relatives and/or friends. For many, providing help for aging parents can be financially, logistically and emotionally challenging. This is why addressing long-term care needs before a major life event occurs can help alleviate some of the stress. Here are four steps to creating a cohesive care plan:

1. CONDUCT A NEEDS ASSESSMENT Put together a list of topics and questions to discuss with your parents. Consider the following: • Family Support – who is available to provide support/care

as needed? • Home Safety – are there safety concerns to be addressed? • Medical/Cognitive – are medical and cognitive health needs

being considered? • Mobility – what assistance with transportation is needed?

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• Legal Documents & Finances – are there plans in place for

paying for long-term care? Have necessary legal documents been addressed? • Housing – is their preference to age at home or move to a senior community? • Socialization – are they getting adequate opportunity to socialize? Communicate your concerns and include your parents in the dialogue on their future needs. If they’re unwilling to discuss

THE PLAN \\ EARLY PHASE

Remember

• Support comes in many shapes • Open the lines of communication before a crisis happens • Understand their financial situation without judgment • It’s not all about you

something you feel is important, agree to a time in the future when they would be willing to readdress. Alternately, they may be interested in writing out their wishes for you to review at a later date.

2. RESEARCH ELDERCARE PROVIDERS AND RESOURCES The current and future needs of your loved one will dictate the types of services and resources you need to look for. Explore available aging options on srgtexas.com.

4. EXECUTE A CARE PLAN Now that you’ve outlined any needs, steps and goals, along with roles and responsibilities, it’s time to put the plan into action. Over time, you’ll need to look for signs and know when to reassess the situation to put updated roles and responsibilities in place. Remember to be flexible and keep an open line of communication on care topics with your loved one.

Start here

To see a Care Plan example and access a free template for you to work from, visit srgtexas.com/caregivertoolkit

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3. CREATE A CARE PLAN Put a plan together that everyone agrees will meet both immediate and long-term needs. See an example of a Care Plan in our Caregiver Toolkit.

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WHAT LEVEL OF CARE IS RIGHT

Understanding the Care Continuum ADULT DAY CARE An ideal option for older adults who wish to age at home but need daytime supervision. Adult day care centers provide services which typically include meals and activities that provide social interaction. Some centers specialize in services for individuals with Alzheimer’s and dementia. HOME CARE/HOME HEALTH For seniors living independently but require assistance. Nonmedical care (home care) or skilled medical care (home health) aim to allow an individual to remain at home by filling any gaps in care. These care services can range from specialized such as wound care to generalized like companionship and housekeeping.

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CONTINUING CARE RETIREMENT COMMUNITY A housing option whereby a spectrum of aging care can all be met within one community. Beginning with independent living, moving to assisted living and finally skilled nursing as needed. All are typically located together on one campus. INDEPENDENT LIVING A housing option for individuals who require little or no assistance with activities of daily living but enjoy access to dining, medical, hospitality and entertainment services. Also known as 55+ apartments or independent/retirement communities.

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Medicare

These types of care typically accept Medicare: • Skilled Nursing Continuing Care • Skilled Nursing Rehab • Home Health Care • Hospice Care

ASSISTED LIVING A housing option similar to independent living but for those who require more assistance and have difficulty with daily living activities. PERSONAL CARE HOME Assisted living in a home-like setting that typically has fewer residents. SKILLED NURSING/ REHABILITATION FACILITY Ideal for those individuals who require constant nursing care. These facilities are licensed and equipped to provide residents with health care that meets the needs of more involved medical conditions.

HOSPICE CARE End-of-life care for the terminally ill, usually via visits in the home or facility of residence.

For a more detailed look at each of these levels of care, visit srgtexas.com.

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ALZHEIMER’S/DEMENTIA CARE Provides special programs and assistance for those with memory loss. Some facilities may provide special security measures.

EARLY PHASE \\ THE PLAN

Why it’s Essential to

RESEARCH SENIOR LIVING FACILITIES

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inding a suitable location for your loved one can be a challenging undertaking. Some facilities may not have a lot of publicly available information, others may have too much, and some may have conflicting details altogether. There are hundreds of senior living facilities located all over the state and narrowing it down to one may be difficult if you haven’t thoroughly vetted your options. People need care in different ways at different stages in their lives; what works for one person may not work for another. It’s important to check if a facility has all the services and features that your loved one is in need of and ensure it’s up to your standards. Services that are non-negotiable should take precedence over those services that could be considered “nice to haves.” For example, if your loved one has been told by their doctor that they need to get daily exercise and spend more time outside, it would be beneficial to find a location that has ample outdoor walking paths. If they’ve suffered from any recent falls or injuries, they may need some occasional assistance or companions to join them on these walks. The facility may indeed have those paths. But upon looking through online reviews, you may discover that the staff is often unable to accompany the resident, and many have found this to be frustrating.

THE PLAN \\ EARLY PHASE

This could be a red flag as you Take these items into consideration when want your loved one to be safe while looking for a care facility still maintaining a healthy and for your loved one. active lifestyle. On the other hand, the reviews • Overview ratings may show you that not only do they Health inspections have ample opportunities for assisted walking trips, they also encourage their Staffing information residents to do so, if they’re physically Quality measures capable, and have an easy-to-use platform to schedule those walks as COVID-19 needed. This would be a nice selling data including point for the property as it shows vaccination percentages of quality of life as well as personal safety. both residents Just because a service or feature is and staff included on the website doesn’t always guarantee that it’s up to standard or Fire safety inspections and readily available to all residents. emergency Doing your research beforehand preparedness is a necessary step in confirming your loved one is getting the care and living Number of penalties arrangements they need. and fines It also helps alleviate some of the anxiety around a new facility and validate any information you’ve already been provided. No two residents are the same and each experience is unique to the individual. However, looking through online reviews and resources can help you identify any underlying patterns or trends. It can also spark questions to ask the intake staff who can provide the answers you’re looking for, and ultimately narrow down your search.

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EARLY PHASE \\ THE ROLE

WHAT TO DO WHEN YOUR PARENTS NEED DIFFERENT LEVELS OF CARE

ne parent requiring advanced care sooner than the other is a probable situation as women and men aren’t statistically equal health wise. When parents require different levels of care, it can be hard trying to balance these circumstances. For example, what if Mom has dementia and needs to move into a memory care community? What is Dad to do? This is similar in some ways to a divorce. However, in this instance, both parties typically want to be together, yet the Prioritize your separation is necessary to maintain health and welltheir health and safety. being too. Taking With the separation, feelings time to refuel of loneliness and social isolation will allow you to can arise. continue supporting The following are ways to help your parents support a healthy relationship through this new and quality of life for both turn in their journey. parents despite their change in environment.

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r e b m e m e R

THE PLAN \\ EARLY PHASE

Step

CREATE A SCHEDULE

A schedule offers routine and structure and will not only benefit your parents but also you. It can help ensure that each parent doesn’t go too long without a family member or friend visiting. Make time for Sunday brunch, biweekly game night or a monthly movie marathon. If a loved one doesn’t live nearby, then schedule virtual visits where the possibilities are endless.

Step

2 PLAN FOR TRANSPORTATION

Step

3 TAKE ADVANTAGE OF TECHNOLOGY

Smartphones, tablets, computers and more allow the opportunity to interact with people even when they’re not physically nearby. With apps such as Zoom and FaceTime, you can quickly connect with loved ones via video. If your parents aren’t tech-savvy, walk them through the process and show them how easy it is to reach their spouse and other loved ones whenever they desire.

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Transportation may be required for various reasons such as taking one parent to visit the other, doctor’s appointments, shopping/ errands, etc. It’s often difficult to arrange for last-minute service, especially if both parents require transportation on the same day. Consider creating a schedule of availability with other loved ones willing to help drive each parent. You could also hire a private companion or care aid who can come spend some time with your parent(s) as well as drive to necessary appointments. For other options, see “Get Connected” on page 26 in the Guide to discover local resources that can help.

EARLY PHASE \\ THE PLAN

Step

4 ENCOURAGE A HEALTHY LIFESTYLE

A positive aspect of living apart is that each parent may have more time to focus on themselves. This offers a wonderful opportunity to build good habits that promote happiness. For example, Mom can enjoy Zumba and chair yoga at the community while Dad sharpens his golf or tennis skills at home. As a result of working on themselves independently, they can cultivate their own strengths and be a better team when they’re together.

Step

5 COMMUNICATE FREQUENTLY

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Check in often with each parent to see how they’re doing both emotionally and physically. Consider that your parents may not want to burden you or voluntarily come to you to voice their thoughts. Try asking yes or no questions like “Do you like how often you’re seeing Mom/Dad?” or “Are you happy with your current daily routine?” to help determine if things need to be adjusted. Creating a standard of open communication can increase the level of comfort and their willingness to share any concerns. Transitioning from levels of care can be physically and mentally draining for everyone involved, but with the tips we’ve outlined and a support system in place for both parents, it should make this phase easier.

FACILITY ID# 110314

EARLY PHASE \\ THE PLAN

WHAT’S AN ADULT DAY CENTER? How it Can Help Caregivers

dult day centers provide care and companionship to seniors in a structured setting, which allow primary caregivers an opportunity to work, catch up on personal items or simply relax. Are adult day centers the same as your community’s senior center? While senior centers are intended for healthy, independent and physically capable older adults, adult day services are for individuals with physical or cognitive limitations. Adult day centers are an ideal option for older adults who wish to age at home but need some supervision. Different programs and services can be found at each adult day center. For example, some centers may specialize in Alzheimer’s or dementia care while others may offer therapeutic exercise, mental interaction, social activities and assistance with personal care. Some centers offer weekend or evening hours, but most operate weekdays during daytime hours. Many provide daily activities, nutritional meals and transportation to and from the center at no cost or on a per-ride basis. Depending on the services offered, costs for adult day care can range from $25 to over $100 a day, according Visit srgtexas.com to the U.S. Administration on Aging. to further your Texas has one of the lowest average understanding and learn: daily rates around $35. • When exactly is the right To find adult day care programs time for adult day service in your area, type your zip code into • What questions to ask the National Adult Day Services when vetting centers Association’s searchable online directory • How to help your loved (found on their website) or contact your one adjust to the new care local Area Agency on Aging.

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EARLY PHASE \\ THE PLAN

OMBUDSMEN ARE HERE TO HELP Courtesy of Texas Health and Human Services

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long-term care ombudsman not only enforces, but also helps nursing home residents to understand their rights. Living in a nursing home doesn’t mean giving up your freedom. If you feel someone is violating you or your loved one’s rights, the Texas Health and Human Services Commission’s long-term care ombudsman can help. Nursing home residents have the same rights and protections of their health, safety and welfare that we all share. For nursing home residents, these rights include the right to vote, voice complaints, exercise personal choice, the opportunity to make medical and social decisions, visit with anyone they wish, and to be lawfully discharged and leave the facility. One of the most common issues one might face when being discharged is to potentially lose their spot in the nursing home they were initially admitted to. This practice, known as “patient dumping,” is among the top five frequent complaints Patty Ducayet, Texas long-term care ombudsman, sees. The long-term care ombudsman will make sure the individual knows their rights, including the right to appeal and return to the nursing home after a hospital stay, and can represent them during that appeal.

THE PLAN \\ EARLY PHASE

Important Number

Call 800-458-9858 to report suspected elder abuse or neglect that occurs in nursing homes, assisted living facilities, day activity and health services. You can also report care concerns about home health and hospice agencies.

Often the most direct and expedient way to ensure your issue is addressed is to inform the skilled nursing facility’s management team, but the Texas Health and Human Services Commission stands by ready to help if needed. According to Texas Health and Human Services, some of the ways long-term care ombudsmen help nursing home and assisted living residents include: • Listening to residents and family members when they have

concerns or issues. • Telling residents about their rights. • Protecting resident health, safety, welfare and rights. • Helping families learn about nursing homes and how to pay

for them. • Working to solve problems and making sure state

“An ombudsman can help bring the resident’s concerns to management and offer ideas to address the concern,” Ducayet said. “An ombudsman can give everyone information about the nursing facility’s requirements about residents’ rights and will tell the resident about the option to report a complaint to HHSC LongTerm Care Regulatory Services.”

Find out more For more information on the ombudsman in your area: 800-252-2412 hhs.texas.gov (search for ombudsman)

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regulations and laws protect residents.

EARLY PHASE \\ CONVERSATIONS

having the conversation:

WHEN DAD DISAGREES ON MOM’S CARE

om and Dad have been together for decades, filled with the memories of good times and bad. Both are getting older, but they may not experience the same impacts of aging at the same rate. Dad, perhaps, is generally fit as a fiddle while Mom may be experiencing physical or cognitive challenges, or both. As dad or the adult children assume the role of the primary decision maker, how do you handle conflicts over care decisions?

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ASSESS THE SITUATION If Dad is providing care for Mom, or vice versa, it’s vital to assess his ability to meet her needs without neglecting his own. Is he missing doctor’s appointments because she can’t stay alone? Is he providing physical care that could cause a fall? If she were to fall, could he get her up on his own? Asking questions like these can help you determine the level of risk and help you decide whether to take the further steps in getting support for your parents. UNDERSTANDING YOUR LOVED ONE’S PERSPECTIVE Before stepping in or implementing formal care options, listen to your dad’s perspective. Consider why he feels the way he does. Older adults are frequently reluctant to accept help. Many emotions are involved. Dad may feel that it’s his job to care for your mom— on his own. He may feel that it’s weak to ask for or accept help, and he may be grieving the loss of his wife as he once knew her.

CONVERSATIONS \\ EARLY PHASE

Advance aging can bring the feeling of losing control, and while Mom may be the one in need of care, Dad may also feel this loss. He may struggle with releasing more of that control to his adult children. Here are a few suggestions for making hard conversations easier: • Start small. Change is hard for most of us! Rather than

making many changes all at once, think about where your loved ones are struggling the most and start there. • Pick your battles. Consider what behaviors really need to

be corrected. Prioritize safety issues such as medication mistakes, driving and lack of eating. It’s crucial to maintain trust between you and your parents. Don’t burn a bridge over a minor difference of opinion. • Spend quality time. In caregiving, it’s easy to get caught up

in day-to-day tasks and forget to spend quality time with your loved ones. You may even feel you don’t have time to enjoy your parents’ company. Think about the favorite activities you used to enjoy together and schedule them into your visits. Try not to bring up the need for help. Enjoying each other’s company breaks up the times when you need to have difficult conversations. It also eases the feeling that you’re interfering and shows them that you value them as individuals.

easier to mull over if they feel far off in the distance. Talk to Dad about what his emergency plan would look like if something were to happen to him and he couldn’t provide the great care he’s providing.

More to Say

For more suggestions and what to do if having a conversation isn’t working, visit srgtexas.com.

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• Call it an “emergency plan.” Sometimes, care options are

EARLY PHASE \\ CONVERSATIONS

hat w w o n K nt they wa

how to talk with

YOUR PARENTS ABOUT THEIR ENDOF-LIFE WISHES

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he conversation involving your parent’s or loved one’s end-of-life wishes is a difficult one. Consider, though, that prolonging this discussion could lead to your mother or father’s inability to share their wishes should they become sick or injured. Without some type of advanced planning, you may be left to make decisions for them, and these decisions could lead to conflict, especially with siblings or other family members involved.

OVERCOMING THE HESITATION TO TALK The fear of saying the wrong thing, or even validating the tender realities of your loved one’s state of being, can lead to hesitation on your part when initiating this very important end-of-life conversation. One way to overcome this hesitation is to share with your parents your thoughts on why it might be important to address these issues sooner rather than later. Perhaps you might share that you’re currently addressing your own future considerations and that it would be sensible to discuss theirs, stressing the idea that lacking a plan could result

CONVERSATIONS \\ EARLY PHASE

in larger issues down the line. By opening up a dialogue about these issues in general, it’s easier to start talking about what your parents want. Ideally, your parents have already begun to consider their end-of-life wishes, but it’s important to understand what those wishes are and what type of plan might be in place already.

There’s more of this article in our Caregiver Toolkit, which offers tips on how you can open a dialogue, what questions to ask, and the important documents and resources to consider when it comes to end-of-life conversations.

Important Documents

For a list of must-know important documents and to read the full article, visit srgtexas.com/caregivertoolkit

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SOME QUESTIONS YOU SHOULD CONSIDER ASKING 1. Have you thought about who you want to make medical decisions for you if you’re not able to make them for yourself? 2. Do you know what kind of medical treatment you want if you become sick or injured? 3. If you need long-term care, do you want to be cared for at home or would you prefer to move? 4. Do you know who you want to handle your finances if you’re not able to? 5. Have you created a will, power of attorney or advanced health care directive?

EARLY PHASE \\ CONVERSATIONS

how to talk with

YOUR SIBLINGS ABOUT CAREGIVER RESPONSIBILITIES Keeping the Conversation Positive and Productive

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ften, there is more than one family member involved with taking care of a parent or aging loved one. If you’re fortunate enough to have a sibling—or more—to rely on when you find yourself in a caregiving role, consider this as a blessing. Unfortunately, it’s not always the case that siblings are willing or even able to help. A family can become estranged over the years, a sibling may be physically or financially unable to provide assistance, or perhaps they simply live too far away. Whatever your situation is, we’ve provided a few tips to begin the conversation with your siblings and to get the support needed for ensuring the best care for both the caregiver and the person they’re providing care for.

SIBLINGS AND ROLES Regardless of whether you are the primary caregiver or your sibling is, caregiving can come with feelings of guilt, frustration and many times helplessness. Personal emotions can sometimes get in the way of making decisions for what’s best for your parent or aging loved one.

CONVERSATIONS \\ EARLY PHASE

HOW TO APPROACH SIBLINGS When we put our differences aside and come to the conversation prepared and without judgment, we place ourselves in a better position of getting the help we need for ourselves, our siblings, and the person for which we’re providing care. Here are a few tips to keep the conversation with your sibling positive and productive: • Try to begin the

Remember the Why

What’s most important is to try and keep in mind that it’s all about caring for your parent(s) or aging loved one and ensuring they have a great quality of life.

conversation while your parent or aging loved one is still healthy and without cognitive challenges. Being proactive will help to ensure that everyone involved will enjoy less stress, and a plan can be put in place for when the time arises.

discussions can be sensitive by nature and are often hard to successfully carry out over the phone or by text. Schedule a time for you and your sibling to meet, and preface the meeting with the topic so everyone has some time to think about what they want to say prior to sitting down together. • If your sibling hasn’t seen your parent or aging loved one in a

while, they may not be aware of the current situation. In this case, bring any helpful documentation such as medical

49 \\ SENIOR RESOURCE GUIDE

• Have the conversation in person if possible. These

EARLY PHASE \\ CONVERSATIONS

visits, diagnosis paperwork, and medication prescriptions to show your sibling your loved one’s current condition. • Discuss all upcoming needs. If it’s time for your parent

or aging loved one to move out of their home, make sure to share this information with your sibling to avoid anyone feeling left out or blindsided. Discuss costs and location and determine whether you can agree on a place, and be sure to share your parent or aging loved one’s wishes. • If you find that the conversation begins to feel contentious,

take a break to allow emotions to settle down. When resuming the conversation, remind everyone that this is an opportunity to make caregiving decisions cooperatively, and agree to move forward by focusing on the tasks at hand. • Ensure that you remain emotionally available and

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supportive to one another. It’s often unrealistic to assume that the responsibility should lie with one sibling. If you are the primary caregiver, make it known that you will need help and how and when they can best assist you. If you are not the primary caregiver, offer your help when possible. It can be hard to ask for help in these situations, however failure to do so can ultimately lead to resentment. No matter which role you are in, empathy and the courage to ask for and offer help will be vital. Be sure that everyone involved is aware of present circumstances, who the primary caregiver is going to be, and where important documents can be found and accessed. These can be challenging and emotional times, so if you find you’re unable to get everyone on the same page, it may be necessary to seek a professional mediator. In the end, when tackling the caregiving process, remember that the whole is greater than the sum of its parts. Defined roles, communication, empathy and perseverance will see you through.

anning Made Easy™ Advance CareCare Planning Advance Plan nning Made Easy™ ™ been be tough. However, when you Made Easy Talking about your end ofdolifeit’swishes can be to

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EARLY PHASE \\ LEGAL + FINANCIAL

FIVE MUSTHAVE LEGAL DOCUMENTS

hether you’re a caregiver yourself, or perhaps interested in getting your own affairs in order, we’ve identified five recommended legal documents that every adult should have. There are many available online resources that explain each document in greater detail and provide free templates for you to create your own. If you have an attorney, be sure to ask them about these types of documents. Don’t wait until it’s too late—take a moment now to get organized.

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1. ADVANCE DIRECTIVE Also known as a living will or health care declaration/directive, this document outlines your wishes for medical treatments and life-sustaining measures, in the case that you’re not able to communicate them verbally. Details might include a “do not resuscitate” order (DNR), the use of breathing machines, tube feeding or organ donation. Making these decisions in advance lets medical professionals know what measures to take and grants your loved ones peace of mind should they have to communicate these decisions for you. 2. DURABLE POWER OF ATTORNEY FOR HEALTH CARE While an advance directive is limited to end-of-life concerns, a durable power of attorney for health care accounts for all

LEGAL + FINANCIAL \\ EARLY PHASE

Online Resources

health care decisions in the case that you’re incapable of making decisions for yourself. In this document, you can outline how your designated power of attorney should act. Their authority to make these decisions ends when you’re once again capable of making your own decisions.

• eldercareteam.com • legalzoom.com

• nlm.nih.gov/medlineplus/ advancedirectives.html • texasnaela.com • texasprobate.com/ professional-forms

3. LAST WILL AND TESTAMENT Many people know this document simply as a “will.” It outlines how your property (including digital property such as email accounts and blogs) should be distributed and to whom. Different states have different requirements for one’s will. In Texas, your will must be signed by two witnesses.

5. FINANCIAL POWER OF ATTORNEY This document designates someone (principal) to do business on your behalf should you be unable to take care of necessary matters yourself. Tasks designated might include paying bills, selling property, managing assets or applying for medical benefits. Unlike a living trust, a financial power of attorney terminates upon the death of the grantor.

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4. LIVING TRUST A living trust designates someone (trustee) to help manage and distribute your assets rather than going through the court system, as in a last will. This often prevents your last wishes from becoming public record. This document also designates terms in which the trustee would set into action should you be unable to make decisions regarding your assets during and after your life.

EARLY PHASE \\ LEGAL + FINANCIAL

PAYING FOR LONG-TERM CARE

ong-term care is a type of personal care service older adults may need if they become unable to care for themselves because of a prolonged physical illness, a disability or a cognitive impairment, such as Alzheimer’s disease. Long-term care can be expensive. Long-term care insurance is designed to cover medical and personal services in a number of settings such as your home, adult day care, skilled nursing facility or assisted living community. Most long-term care insurance policies are individual policies and can differ from one company to the next. According to medicare.org, long-term care may be divided into three levels: Skilled care is continuous “around-the-clock” care designed to treat a medical condition and performed by skilled medical personnel, such as registered nurses or professional therapists. Intermediate care is intermittent nursing and rehabilitative care provided by registered nurses, licensed practical nurses, and nurse’s aides under the • Medicaid supervision of a physician. • Medicare Custodial care is designed to assist with one’s activities of daily living (such • Long-term care insurance as bathing, eating and dressing). It can be • Long-term care provided by someone without professional riders attached medical skills but is supervised by a to a life insurance physician. policy or annuity Texas created the Long-Term Care • Accelerated death Partnership Program, which is a joint effort benefits from life insurance between private insurers and the state. For a list of companies participating in the • Personal cash or savings program visit: tdi.texas.gov/consumer

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EARLY PHASE \\ INITIAL MEDICAL CARE

UNDERSTANDING MEDICARE:

Parts, Plans and Meeting Your Needs Courtesy of Sharon Wagner, seniorfriendly.info

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any Americans who enter into Medicare do so with a sketchy understanding of how the system works. That’s rather alarming considering how much older Americans rely on Medicare for their health care needs. It’s essential that seniors and their caregivers understand how the program works to avoid missing out on important benefits and paying unnecessarily high costs. Sometimes, the best approach is to start from the beginning when unraveling a complex subject like Medicare.

PARTS OF MEDICARE When you sign up for Medicare at age 65 you’re automatically enrolled in Plan A, which is hospital coverage, and Plan B, which covers outpatient coverage. Part A covers room and board in a hospital or skilled nursing facility, while Part B covers things like doctor visits, surgeries, lab work, equipment and diagnostic tests. Prescription drugs are covered under Part D, which provides a card that allows you to buy prescription medications at a significantly lower cost than retail. Part D insurance is voluntary coverage, but it’s a key part of the system because paying out-ofpocket for medications can be extremely expensive.

HOW THE PARTS WORK Your Medicare Part B coverage is based on income, with enrollees starting at a base rate of $135.50 while higher-income enrollees pay an “income adjustment” (meaning they pay more for Medicare). Part B is a necessity; you can’t purchase supplemental insurance unless you have both Part A and B. If you’re working for a large employer, your health insurance there continues as your primary with Medicare playing a secondary role, meaning you can delay enrolling in Part B if your group insurance already includes outpatient benefits. Part B covers 80% of medical services, with your share being the remaining 20%. Certain treatments and procedures can be quite expensive, which means you could end up with a hefty co-pay. Part D has built-in co-pays for medications, so you won’t need supplemental insurance for the cost of needed medications.

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INITIAL MEDICAL CARE \\ EARLY PHASE

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MEDICARE ADVANTAGE Choosing the right supplemental coverage is one of the most important decisions you’ll make as a Medicare enrollee. Fortunately, you can select plan options based on your budget. Medicare Advantage, also known as Part C, offers plans that provide a low-cost alternative to Medicare. These plans have their own local network of providers and usually have lower premiums than Medigap, though there are co-pays for hospital stays, doctor visits and other approved services. Medicare Advantage also has a folded-in version of Part D, though it’s important to remember that it may not include the specific medications you need.

INITIAL MEDICAL CARE \\ EARLY PHASE

DECIDING WHETHER MEDICARE ADVANTAGE COULD BENEFIT YOU Check to make sure your doctor is in-network and accepts Medicare Advantage (some accept original Medicare instead). Keep in mind, most Advantage plans are good about pairing you with a specialist if your doctor is out of network. You’ll also want to make sure any medications you take are covered. If you take several prescriptions and have reached the “donut hole,” the annual limit on what Medicare Advantage will cover (between $3,820 and $5,100 on covered medications), bear in mind that Part D enrollees get a 75% donut hole discount on brand-name drugs starting at $3,800. Consider also your out-of-pocket costs if you anticipate health care expenses. You can always choose a plan with lower out-of-pocket costs. Check out the plan finder at Medicare.gov to find Medicare Advantage plans in your area that meet your needs. Note that plans such as Humana Medicare Advantage have extensive benefits, including vision and dental coverage as well as an innovative fitness program called SilverSneakers, which provides access to over 13,000 fitness centers. It’s important to understand the Medicare system so you can find the coverage you need. As you compare and contrast plans, carefully check network provider and covered prescription medication lists. And stay abreast of the changes which frequently occur with Medicare. It also helps to know that if your plan doesn’t work for you this year, you can change it next year.

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MEDIGAP As mentioned, Medicare pays 80%. A Medigap plan pays the other 20% of your Part B outpatient expenses. Some Medigap plans also cover Part A and B deductibles, though you purchase your own stand-alone Part D coverage since Medigap doesn’t cover prescription medications.

EARLY PHASE \\ INITIAL MEDICAL CARE

A GUIDE TO MEDICATION OBSTACLES “I was discharged from the hospital with so many new medications and don’t even know what I’m taking them for.” As your senior’s health changes, medication requirements often change as well. Oftentimes, hospital stays result in several medication changes, including adjustments in dosages, removal of some, and the addition of new ones. This cumbersome process can leave room for errors. Fortunately, there are steps you can take that may help prevent errors when medication changes occur. Prior to being discharged, ask the nurse to review the updated list of medications with you. It’s important for you and your loved one to understand the reason they’re taking Repeat back what each medication. each medication is You’ll also be given a list with and what they treat. this information on the discharge This tactic will help paperwork. If any of this information in becoming familiar looks inaccurate or confusing, ask the with each. nurse to check with the doctor or other health care providers to confirm accuracy. If possible, have a family member or friend with you during this time. There’s typically a lot to take in at once, and they can assist with asking any clarifying questions as well as taking notes. Follow up with their primary care provider after any hospitalization. The provider can review the discharge medications with you and update their medical records. This is

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Discharge Tip

INITIAL MEDICAL CARE \\ EARLY PHASE

“I’ve been out of my medication for three days. I’m not sure how to get more.”

Create a List Include each medication with an explanation of what it treats. Doing so may bring to light any medications that are duplicating efforts or no longer necessary. Keep the list—a printed and digital copy—easily accessible in case of emergency.

Another obstacle is running out of medication. Making a plan of how your loved one will access medications is essential and may help prevent missed doses. If transportation is an issue, look into mail delivery options, which can bring medications right to their doorstep, or seek assistance from family members or friends. Home caregivers, aides or companions are also available to provide transportation to the pharmacy. Keeping a schedule with estimated refill timeframes for each medication will help keep them on track and prevent missed doses. Try to make it a habit of refilling medication a few days or a week before they’re out. Perhaps the medications are too expensive, and your senior loved one can’t afford them. If they are struggling to pay for medications, ask the primary care provider about alternate medication options or the pharmacy for recommended resources. The medication obstacles your loved one faces can be difficult, but remember there’s a lot of help available. Your health care team, family and friends are all important resources who can work together with Your loved one may you to ensure your loved one takes have spilled some their medications as prescribed. With pills, misplaced the support of everyone involved, it’s the bottle, or possible to overcome any obstacle accidentally taken and maintain excellent medication an extra dose. compliance.

Make Checkpoints

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also a great opportunity to discuss any further questions you or your loved one may have after leaving the hospital.

EARLY PHASE \\ INITIAL MEDICAL CARE

MOBILE CARE TELEMEDICINE PROVIDERS

The following offer a “digital visit” via an app, cell phone or computer.

Austin Geriatric Specialists 512-477-4088 agsaustin.com

Be Well MD 512-553-1921 stayhealthystayhome.com

CommuniCare 210-233-7000 telemedicinesanantonio.org

Docster Telemedicine 281-362-7837 docster.us

Doctor At Your Service 210-570-9975 doctoratyourservice.com

Healing Hands House Calls PLLC

HOUSE CALL PHYSICIANS

When getting to the doctor’s office is prohibitive or not practical, consider a physician who makes oldfashioned “house calls.”

Capitol House Calls 512-459-5204 (Austin area) capitolhousecalls.com

DispatchHealth 737-356-2604 (Austin area) 210-891-5236 (San Antonio area) dispatchhealth.com

Integrative Medical Home Care 512-906-0168 (Austin area) imedicalhomecare.com

The Medical Team 512-418-9555 (Austin area) 830-626-3525 (New Braunfels area) 210-227-9900 (San Antonio area) medicalteam.com

210-560-5841 healinghandshousecalls.com

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Ministering Physicians 512-246-6170 ministeringphysicians.com

Visiting Physicians Association (VPA) 512-407-8880 (Austin area) 210-468-0800 (San Antonio area) visitingphysicians.com

Denotes Telemedicine Providers who also offer house call visits.

Free Transportation for 60+ to medical appointments, grocery shopping and other essential errands. Visit our website for program services or to volunteer: driveaseniorcentraltexas.org.

512-445-5552

...enriching lives and communities by providing transportation and socialization to non-driving seniors, helping them to age in place.

MID PHASE \\ DAILY CARE

How to Handle

RESISTANCE TO BATHING, EATING & MEDICATIONS

ifficult aging behavior can take a huge emotional and physical toll on the family member who is providing care. Learning to navigate these changes is critical to developing caregiving endurance. Let’s walk through a few common scenarios that frequently pop up for family caregivers. It’s important to keep in mind the symptoms will vary from one person to the next, and for any given individual, what works one day may not work the next. So, keep these tools in your back pocket.

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RESISTANCE TO ACTIVITIES OF DAILY LIVING: BATHING, EATING & MEDICATIONS As needs change, your loved one may need assistance with personal care. This is an area that can often cause stress, which may result in anger or agitation. The family member may refuse

Tap Out

It’s not uncommon that your loved one may at times respond better to someone other than you. Are there friends, family members or professional care providers to whom your loved one may be more receptive? Is there someone who can physically step in with a different approach or provide a distraction over the phone?

your assistance because they may not see their need for help, or they could be seeking to remain in control. Consider how you can present the task without bringing attention to their challenges. At shower time, you might say that you bought a new product and you’d love for them to try it. When you place a meal in front of them, say you made a big dish and have leftovers. In the same way, preparing your loved one’s medications is a convenience for you—you were in the kitchen, so you got them ready. If your loved one is apprehensive about the pills themselves (perhaps even suspicious), try to connect them with something positive, such as staying healthy to see the grandkids. Statements like these provide a cue without being accusatory. They maintain your loved one’s dignity and feelings of independence by drawing attention away from their need for your help. When it comes to personal hygiene, hands-on help may

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A Little Reminder

The most challenging behaviors are often directed at the primary caregiver simply because you’re the one who has the most trusting relationship with the aging family member. It’s important to keep in mind that your loved one doesn’t have control over their symptoms, and what they say in a painful moment is not personal, nor is it a reflection on the care you provide.

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be scary for some people. Try to make the experience more pleasant. Think about temperature, smells, music. Anything that can make the surroundings more pleasant can help a difficult situation feel more comfortable or familiar. This can create a dementia-friendly environment. Instructions to your loved one are best kept short and sweet. Anger and agitation that arise during personal care are typically a way of communicating their needs. Being mindful of what they’re trying to express can guide you to the most appropriate response.

PREVENTING TRIGGERS The family member in your care may exhibit outbursts even without any triggers. When they experience anger, agitation, and other challenging symptoms, keep track of them in a journal. Journaling their symptoms can help identify any consistent triggers. Write down what happened leading up to the outburst and record what strategy was successful in de-escalating the symptoms. While the strategies to deal with the situation can help your senior get through a difficult moment, avoiding the trigger in the first place can keep the situation from developing or escalating. However, avoidance may not always be possible, so keep this formula in mind: validate their feelings; provide a simple (even temporary) solution; and redirect to a more pleasant activity.

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WHEN DO YOU NEED TO CONSIDER IN-HOME CARE?

It May Be Time to Look for Assistance

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s we age, there are certain issues that we, or those we love, may eventually face when doing simple household chores, such as laundry, cleaning or grocery shopping. These issues tend to arise from normal changes in our physiology including lack of mobility, vision changes, and physical dexterity to name a few. With these changes, we often find that there's an increased need for help with necessities like bathing, dressing and meal preparation. When this happens, it may cause you to wonder if it’s time to hire in-home care or move to an assisted living facility. Irrespective of your search for a caregiver for yourself or for a loved one, in-home care could be the ideal option. Though research shows that most older adults prefer to age in place in their own home, there are many questions raised by older adults or their informal caregivers regarding home care. In this article, we provide answers to a few questions you may have regarding in-home care. It may be time to look for assistance when signs of decline begin to appear during various activities of daily living.

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From the Experts

Learn what aging signs you should be on the lookout for in the full article: srgtexas.com/caregivertoolkit

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Many adult children who are caregiving may cohabitate with their parents. However, working adults may also have responsibilities that don’t allow them to provide care during the day. As time carries on, the dishes begin to stack up in the sink, the laundry piles up, and your parent is found in the same chair you left them in when you return home. Then the realization hits—your parent hasn’t had a shower in a long period of time. Perhaps even more tricky is when your loved one lives alone, and you notice a similar situation as noted above with the dishes, laundry and hygiene. You might notice that the mail has piled up and bills aren’t being paid or medication refills go unfilled. There’s also the scenario where your aging parents are living independently, however, you begin to notice a decline in the health of the parent who typically provides care for their spouse. The stress of providing care can take a physical and mental toll on even the most experienced caregivers. In-home care can provide respite for the caregiver, which can allow for some muchneeded rest and time for self-care. Give yourself permission to take a break! These are just a few examples of when to consider exploring in-home care options. Moreover, receiving care assistance enables you to focus on spending quality time with your loved ones and less time worrying or stressing over daily care needs.

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HOME CARE VERSUS HOME HEALTH CARE HOW CAN I DETERMINE IF HOME CARE IS NECESSARY? When self-care at home becomes difficult and/or family caregivers are not available to assist, home care may be the answer. Home care often relieves family members of basic caregiving functions and makes it possible to spend quality time, rather than the functional caregiving time. Home care is often easier and faster than moving to an institutional care setting and allows the senior to stay at home in familiar surroundings. WHAT IS HOME HEALTH CARE? When the need exceeds what home and personal care can provide, a home health care agency may be required. Home health care provides skilled medical services (such as administration and adjustment of medication levels, monitoring and dressing of wounds, etc.) in the home by trained medical personnel. Home health care is always ordered and supervised by a physician.

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FIND HOME CARE + HOME HEALTH

Local options!

CarePatrol of Central and South Austin

CarePatrol of NW San Antonio, Hill Country

512-798-3142

726-201-4040

CarePatrol of North Austin

Halcyon Home (Austin)

Halcyon Home (San Marcos)

866-560-5656

512-815-9009

512-667-6775

DAILY CARE \\ MID PHASE

Ease into it

WILL MY INSURANCE COVER THE COSTS? Medicare, Medicaid and private insurances are sources of payment for receiving home and home health care. Home health care services are typically medically necessary. They are paid for by Medicare or other health insurance, and have been ordered by a physician. Private duty home care services are typically paid for privately, or using long-term care insurance, reverse mortgage proceeds, Veterans aid and attendance pension benefits, or some combination of any of these programs.

Based off advice from the Family Caregiver Alliance, here are tips for introducing a home care service into your loved one’s routine. • Start slowly. Gradually add hours as needed and allow time for your loved one to get used to the idea. • Listen and acknowledge your loved one’s feelings, and possibly fears, about hiring home care. • Involve your loved one in the hiring process as much as possible. • Consider alternative motivators. Using a doctor’s recommendation, the need for housekeeping or help with preparing meals might make your loved one more comfortable with the notion.

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WHAT IS HOME CARE? Simply put, home care is nonmedical personal assistance provided in the home. Home care may include help with bathing, dressing and personal hygiene. It may include a wide range of services: taking and recording vital signs, assistance in the bathroom, light housekeeping, meal preparation, companionship, grocery shopping and pharmacy errands, home safety supervision, medication reminders, bill-paying, laundry and transportation.

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6,349 volunteers in 2021

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Call (512) 763-1400 to inquire about receiving meals

$7 feeds a senior for 1 day Visit our website www.owbc-tx.org to give today

STAY CONNECTED @OpportunitiesforWBC

@Opportunitiesforwbctexas

(512) 815-9009

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Why choose the Rave 2 stair lift?

MID PHASE \\ DAILY CARE

THEFT ACCUSATIONS FROM A SENIOR: Real or Not

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aring for an aging family member, whether at home or in a senior living community, can put stress on the family. If your loved one suddenly begins making accusations of theft or abuse, the stress is multiplied exponentially. It can be terrifying to think that your loved one may be suffering and a victim of some form of mistreatment, but don’t leap to conclusions. There are a variety of situations in which an elderly person might make false accusations against caretakers or other residents. As sad as it may be to consider this possibility, it must be done in order to determine the truth behind the accusation and provide the necessary help and support for your loved one. In this article, we’re covering the circumstances that might give rise to theft accusations from an aging loved one, and some suggestions on how to deal with them whether they’re true or groundless. There are also tips on what to look for to help determine whether theft has occurred.

DEMENTIA AND DECLINE Seniors with dementia are frequently confused and disoriented. These senior delusions can be intense and cause them to put themselves or others in danger, which is what usually prompts their admission into a senior living facility.

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“YOU/THEY ARE STEALING FROM ME” Seniors suffering from memory loss and cognitive decline, especially those with dementia, have a hard time remembering where they put things. Frustration and pride can result in suspicions of theft by their caregivers, even if the caregiver is a family member or friend. Senior delusions of theft are common--so don’t take it personally or be alarmed. A study of 110 patients found that 31% had paranoid delusions, and that of these delusions, theft (28%) was most common.

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Even when dementia isn’t present, a decline in cognitive abilities and a gradual loss of short-term memory can make the world around them a scary, frustrating place. These negative feelings, in addition to dementia, Alzheimer’s or a more gradual memory loss and confusion, can easily lead to paranoia that results in false accusations of theft or abuse.

MID PHASE \\ DAILY CARE

HANDLING FALSE ACCUSATIONS OF THEFT Familiarize yourself with their common stashes, and what they keep there, so you’ll know where to look when something is lost. Take the blame. Instead of arguing, just say, “I must have misplaced it while I was cleaning. Let me go find it for you.” Buy duplicates of items that are frequently misplaced and use them as replacements when they go missing. If your senior can still read, carefully label where things should go around the house or their senior living accommodation. WHAT TO DO IN THE CASE OF THEFT Sometimes, theft is real. Seniors are extremely vulnerable and are often targeted. Some signs theft may be occurring in the senior living facility: • Something is missing and neither your loved one nor you

can find it. • Staff at the facility dodge or avoid your questions about the

item. • Caregivers don’t allow you alone time with your loved one.

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• The item missing is particularly valuable.

By law, every nursing home must have explicit policies and procedures for responding to theft. These should be provided to each resident or resident representative when the admission contract is completed. If you don’t have it, ask for it and review it. Immediately report the theft to the nursing staff, administrator, local ombudsman, and licensing department. They should record each missing/stolen item with a value of $25 or more. If the value is $100 or more, it should be reported directly to the police. Ask the facility whether it has a policy for replacing lost items.

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You can seek help from a local ombudsman program, which is focused on supporting policies and consumer protections to improve long-term care at the facility, local, state and national levels. Homeowner’s insurance may cover certain losses if your senior receives home care. Check to see if your insurance covers the lost item. If a loved one is accusing a family caregiver of theft, you must address it with the family member in question and see if it has any merit.

Other allegations of wrongdoings that seniors most commonly make include: • “I’m being poisoned” • “I’m being held prisoner” • “I’m being abused”

If you believe your loved one is being mistreated, definitely seek help. Your first steps should always be to share your concerns with the senior living facility, doctors who see them regularly, and anyone else close to them. If you find abuse, report it. You can call Texas Health and Human Services Commission at 800-458-9858.

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Important to Know

MID PHASE \\ SELF CARE

5-MINUTE COMFORT Recipe adapted from minimalistbaker.com

ozy up with a cup of creamy, chocolatey, chill vibes, and help your body take the edge off any stress. Adaptogens are said to help reduce fatigue, alleviate anxiety, and boost the immune system. This hot chocolate recipe incorporates three adaptogens that are widely available: Ashwagandha (most well-known for its ability to help our bodies adapt to stress and potentially lower cortisol), Maca (packs serious health benefits including balancing hormones and increasing energy levels), and Reishi mushroom (especially good for helping our bodies relax).

ADAPTOGENIC HOT CHOCOLATE RECIPE

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Makes 1 serving

INGREDIENTS

DIRECTIONS

• 10 ounces very hot water (or sub favorite dairy-free milk) • 1 tablespoon unsweetened cacao powder (or cocoa powder) • 1/2 teaspoon Ashwagandha • 1 teaspoon Reishi mushroom powder • 1 teaspoon Maca • 1 teaspoon coconut butter • Maple syrup (or raw honey) to taste • 1/8 teaspoon cinnamon

In a small saucepan over medium-high heat, add water and begin to warm it. Once it starts to simmer, remove from heat and pour directly into a blender. Add remaining ingredients to the blender and blend on high until creamy and frothy (approximately 1 minute). Taste and adjust flavor as needed, adding more sweetener to taste, cacao for rich chocolate flavor, maca for malty flavor, or coconut butter for coconut flavor/butteriness. Serve and enjoy immediately.

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MEANINGFUL MINUTES FOR CAREGIVERS

Creating Space for Yourself to Recharge

aking time for yourself may seem impossible, but try carving out 5 minutes in your day to press pause. It can make a world of difference. Consider turning your phone on silent mode and stepping away to:

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GET FRESH AIR. Open your windows or simply step outside to take in a new environment. A fresh atmosphere is excellent for resetting your mind and body, which can help you feel calmer. If you have the time, go for a walk or run to boost endorphins. MAKE A GRATITUDE LIST. Write down 10 things you’re thankful for. Shifting your mind to appreciation and finding the positive in your day cultivates a new perspective. The 10 items can be relatively small or large. Try to be as specific as possible and give thought to the reason you’re grateful for each of them. For example, you may be grateful you were able to pick up dinner for your mom because you received a huge smile from her. Or you could be thankful for your bed, pet, laughter, alarm clock, etc. In the words of Oprah Winfrey, “Be thankful for what you have; you’ll end up having more. If you concentrate on what you don’t have, you will never, ever have enough.”

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JOT DOWN YOUR THOUGHTS TO CLEAR YOUR MIND. If you’re feeling overwhelmed or as if your tasks and demands are never ending, grab a piece of paper (or open a notetaking app on your phone) and unload your thoughts. Don’t attempt to organize them. Simply write them out as they pop up in your mind—things you’re worried or happy about, obligations, items on your to-do list or projects. Decluttering the mind and slowing down spiraling thoughts can help sort out a frazzled mind, but also may help clarify emotions. Additionally, the act of writing down any bright spots in your caregiving journey encourages calm and may help store it in your memory.

• lower our heart rate and

cortisol levels • release endorphins and improve

our sense of well-being • distract us, reducing physical and

emotional stress levels

More 5-minute ideas: • Make yourself a cup of tea or coffee • Five-minute breathing exercise

• Meditate (or just close your eyes and relax) • Read a short article of interest • Stretch • Take a power nap • Chat with a friend or family member

Music is a fantastic way to relieve stress. While some types of music, such as classical and ambient, have been studied for their calming effects, listening to your personal favorite song or genre also has its benefits. Whether it’s been a stressful day or you’re just looking for some good vibes, take a moment to turn on Spotify or queue Alexa to play “Dancing Queen” by ABBA. Listening to music that makes you feel good will help put a smile on your face. Additionally, research has shown that music can help reduce burnout and help you fall asleep. However you spend your five minutes, make the most of it. Fully dedicating time for yourself allows your mind and body the opportunity to recharge.

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LISTEN TO A FAVORITE SONG. According to Psych Central, a 2020 overview of research into music and stress suggests that listening to music can:

MeTime

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FIVE VITAL TIPS TO HELP DEAL WITH CAREGIVER STRESS

And Recognizing Unhealthy Stress Levels

ccording to the National Alliance for Caregiving and AARP, around 34.2 million Americans provided unpaid care to an adult age 50 or older in 2020. Many of these caregivers also care for other family members, such as children, and work outside the home. Without assistance from others and appropriate self-care, it’s a recipe for caregiver stress, fatigue and eventual burnout. In this article, we’re going to talk about recognizing when your stress levels are getting too high and some tips for dealing with caregiver stress.

SIGNS THAT YOU MAY BE TOO STRESSED Everyone copes with stress differently, but if you find yourself experiencing any of the symptoms below, then your stress might be progressing to unhealthy levels. • Feeling run-down or tired often • Difficulty sleeping

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• Trouble concentrating • Resenting obligations • Not taking care of your own health • Smoking, drinking or eating too much • Cutting back on activities that you usually enjoy

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The good news is there are ways to deal with caregiver stress and keep it in check.

Tip

DECIDE WHAT‘S IMPORTANT THEN SAY “NO” TO THE REST.

No caregiver is perfect, and it’s impossible to do everything all the time. Prioritize what you or your family member needs that is most critical and break that down into small, easier-tomanage steps. It’s okay to say “no” or even just “not right now” to tasks that drain you. You don’t have to cook a homemade meal every single night, host holiday get-togethers or have the most well-kept yard in the neighborhood. Focus on what matters and cut the rest, especially in times of stress.

Tip

Very few people can do everything alone. Tap into the network of friends, family and social services around you to lighten your own load. Even if they live far away or can’t help with hands-on care, you can delegate tasks that can be done online or over the phone. Many state, local and religious organizations also have resources available to help senior adults and caregivers. Why not task a helpful friend or family member to look through what’s available and pick out the most promising services? They can also assist with applications and coordinating services.

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2 TAP INTO THE RESOURCES AROUND YOU.

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Tip

3 SIMPLIFYING COMMUNICATIONS.

If your loved one has experienced unstable health lately, you may find yourself on the phone giving multiple updates to friends and family. While they mean well, it can get exhausting for you to rehash the same information and answer the same questions repeatedly. You can cut back on your update workload considerably by employing a phone tree (where you update one person and they pass the information to other designated people) or using private websites that allow you to post updates but still have privacy controls like CaringBridge or PostHope.

Tip

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4 PERSONAL HEALTH ROUTINE. SET AND FOLLOW YOUR

It’s easy to forget about your own health when you’re busy caring for someone else. Research has shown that caregivers, particularly female caregivers, have lower levels of self-care and higher rates of health problems than non-caregivers. Developing your own simple routines to get enough sleep, water and exercise can help to improve your health and lower stress. Don’t put off recommended health screenings and checkups. You’ll be a more effective and less-stressed caregiver if you make taking care of your own health a priority as well.

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Tip

5 TAKE CAREGIVING BREAKS REGULARLY.

FINAL THOUGHTS Taking care of a senior adult can be very rewarding, however there’s no doubt that at times it can also be stressful. Unrelieved stress can build up over time and damage your own health and your ability to care for your loved one. By prioritizing activities, reaching out for assistance, simplifying communications with friends and family, taking regular breaks from caregiving, and sticking to your own personal health routines, you can reduce the amount of caregiver stress that you feel. In the long run, this will help both you and your loved one to thrive during potentially difficult times.

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Schedule time for yourself and do not waver. These breaks can be small, like a walk around the block or coffee with a friend while your loved one sleeps. Consider asking a family member to visit for the weekend so you can take time away to recharge. If you don’t have anyone in your personal circle who can take over caregiving duties on occasion, there are also networks of professionals available. Many communities have resources such as in-home respite care, adult day care centers or programs or senior living communities with short-term stays available.

MID PHASE \\ DIET + WELLNESS

CHANGES IN A SENIOR’S APPETITE: WHAT’S NORMAL?

lthough diet fluctuations are common among seniors, it can be worrying to observe these changes in a loved one. It’s important to be mindful of this and to promptly address and prevent issues before they become more serious. Proper nutrition is imperative as you age as it not only helps an aging individual stay strong and healthy, but also aids in recovery from any ailments. A senior with no appetite can prove to be a difficult challenge. Let’s dive a bit deeper into some of the factors associated with your loved one’s low appetite, and perhaps most importantly, how to help.

UNDERSTANDING WHAT CAUSES THE LOSS OF APPETITE As people age, their metabolic rate slows, and their physical activity decreases too, which results in them needing fewer calories. While seniors need fewer calories, it’s essential that more nutrition is packed into each meal. Although some change in a senior’s appetite is normal, there are several factors that can contribute to this issue, such as:

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• A lack of energy to cook • Changing taste buds, making eating less pleasurable • Loneliness and depression • Difficulty chewing or swallowing • Side effects of medication • Health conditions

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Tricks to Stimulate Appetite

ADDRESSING APPETITE CHANGES IN THE ELDERLY Loss of appetite in seniors could be a result of various factors, but you can help by monitoring any noticeable changes, trying out different methods to spark their appetite, and recognizing when it may need to be addressed by a doctor. You may also consider in-home care or a meal delivery service for your loved one. These ideas ensure your loved one has someone around to eat with or access to an easy and convenient meal. If circumstances seem beyond these measures, consider consulting a specialist.

Discover more powerful tips + tricks to handle diminishing appetites at srgtexas.com/caregivertoolkit

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In some cases, loss of appetite could be a sign of a more serious condition or illness. When seniors don’t show any desire to eat, express that they don’t feel hungry, or start experiencing unwanted weight loss, there could be an underlying medical condition. • Offer smaller An underlying cause can certainly portions of be to blame if your loved one nutrient-packed consistently expresses they are fatigued food with very little appetite. Medical • Brush their teeth conditions that might contribute to before eating loss of appetite in seniors include: • Get them to eat kidney failure, thyroid disorders, with others hepatitis, chronic liver ailment, Alzheimer’s disease or dementia, chronic obstructive pulmonary disease (COPD), some cancers. If you notice that a loved one is experiencing a decreased appetite that continues to worsen, or if they are losing weight without trying, consider contacting your health care provider soon.

MID PHASE \\ DIET + WELLNESS

SPECIAL DIETFRIENDLY SOUP Recipe adapted from cookieandkate.com

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aturally high in fiber and rich in vitamins, cauliflower provides antioxidants and phytonutrients that may reduce the risk of several diseases, including heart disease and cancer. Additionally, it’s weight loss friendly and can help detoxify the body. This hearty soup featuring cauliflower will warm you up without weighing you down. It’s rich in flavor and can easily be prepared to accommodate a keto, paleo, gluten free, dairy free or vegan diet.

Bon appétit

Find more recipes on srgtexas.com

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CREAMY ROASTED CAULIFLOWER SOUP RECIPE

Makes 4 servings

INGREDIENTS • 1 large head cauliflower (about 2 pounds), cut into bite-size florets • 3 tablespoons extra-virgin olive oil, divided • Fine sea salt • 1 medium red onion, chopped • 2 cloves garlic, pressed or minced • 4 cups (32 ounces) vegetable or bone broth • 2 tablespoons unsalted butter • 1 tablespoon fresh lemon juice, or more if needed • ¼ teaspoon ground nutmeg • Optional for garnish: 2 tablespoons finely chopped fresh parsley, chives and/or green onions

Preheat oven to 425 degrees Fahrenheit. If desired, line a large, rimmed baking sheet with parchment paper for easy cleanup. On the baking sheet, toss the cauliflower with 2 tablespoons of olive oil until lightly and evenly coated. Arrange the cauliflower in a single layer and sprinkle lightly with salt. Bake until the cauliflower is tender and caramelized on the edges, 25 to 35 minutes, tossing halfway. Once the cauliflower is almost done, warm the remaining 1 tablespoon olive oil over medium heat in a soup pot. Add the onion and ¼ teaspoon salt. Cook, stirring occasionally, until the onion is softened and turning translucent, 5 to 7 minutes. Add the garlic to the pot and cook, stirring constantly, until fragrant, about 30 seconds, then add the broth.

Reserve 4 of the prettiest roasted cauliflower florets for garnish. Then transfer the remaining cauliflower to the pot. Increase the heat to medium-high and bring the mixture to a gentle simmer. Cook, stirring occasionally, for 20 minutes, to give the flavors time to meld. Once the soup is done cooking, remove the pot from the heat and let it cool for a few minutes. Then, carefully transfer the hot soup to a blender, working in batches if necessary. Add butter, lemon juice and nutmeg and blend until smooth. Add additional salt or lemon juice, to taste. Top individual bowls of soup with 1 roasted cauliflower floret and a sprinkle of chopped parsley, green onion and/or chives. Store leftovers in the refrigerator covered, for 3-4 days, or for 1-2 months in the freezer.

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DIRECTIONS

MID PHASE \\ MEMORY + DEMENTIA

GETTING A DEMENTIA DIAGNOSIS And the Steps to Take Immediately After

he days following a loved one’s dementia or Alzheimer’s diagnosis can be difficult and filled with emotion. For many, the lack of knowledge is often scarier than the diagnosis itself as you have no idea what to do, what to expect or how you’re supposed to help. We’ll examine this topic and discuss those critical first steps to take following this type of diagnosis, as well as how you can provide the best care possible.

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STEP 1: CONSULT A SPECIALIST.

Alzheimer’s and dementia diagnoses are often made at the hospital following a significant event or at a primary care physician’s office after the onset of some cognitive symptoms. However, if you or your loved one haven’t spoken to a neurological specialist, it’s highly recommended. This is because dementia isn’t always caused by unstoppable neurological degeneration. It can result from several medical conditions, such as heart disease, intracranial pressure, or a mass located at certain spots within the body. It can also be the result of certain medications, such as anticholinergic and bladder antimuscarinic (bladder suppressant) drugs. If this is the case, you’ll want to know so you can obtain the most effective treatment.

STEP 2: CONSIDER YOUR OPTIONS.

Alzheimer’s and dementia don’t currently have cures, but there are treatments and medications available to help improve

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symptoms. Make sure you talk this possibility over with your loved one’s doctor and keep up to date on new findings and treatment options. Questions to ask your loved one’s doctor: • What tools or tests were used to determine a diagnosis?

What were you measuring? • What is causing the illness? • What are the treatment options available? • What symptoms are alleviated by each medication and are

there any side effects? • Are there any clinical trials available, and where can I find

additional information on those? • How will the disease progress? • What forms of care are available to help my loved one live

with the disease? You should also be considering what long-term care may look like. For most adults with a memory-targeting illness, longterm care often involves professional at-home caregivers or a specialized 24-hour facility.

Receiving a degenerative memory diagnosis is never easy, and it’s important to recognize and cope with any emotions you may have. Although your loved one is still around, feelings of loss, anger and fear are common. Coming to terms with the diagnosis will help you and your loved one move forward and discover new ways to live a positive and fulfilling life.

Six More Steps

There’s more of this article in our free Caregiver Toolkit. To learn more critical first steps, visit srgtexas.com/caregivertoolkit

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STEP 3: TAKE CARE OF EMOTIONAL NEEDS.

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*$19.95 is the monthly price of subscription to a MobileHelp Classic at home only system. There is a one-time $49.95 processing fee and $15 shipping fee required to subscribe to this plan. Equipment may vary as shown. System featured in photo above is the MobileHelp DUO available at an additional monthly cost. Call or see terms and conditions for further details. 50% off Fall Detection Promotion valid when Fall Detection Service is added to your monitoring system and MobileHelp Connect Premium service is included with the order. Offer is valid for the first year of service only. This offer is for new customers only and cannot be combined with any other offers. Promotion available for select plans only and for a limited time. During the promotional term, you will receive $5 off the $10 full retail price of Fall Detection service. After first year, Fall Detect pricing reverts to discounted price of $7.50/ month when combined with MobileHelp Connect Premium. Fall Button does not detect 100% of falls. If able, users should always push their help button when they need assistance. Fall Button is not intended to replace a caregiver for users dealing with serious health issues. Service availability and access/coverage on the AT&T network is not available everywhere and at all times. Current GPS location may not always be available in every situation. MobileHelp is a registered trademark. Patented technology. MobileHelp is an FDA registered company. MHPN-00939 Rev. 1

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TIPS FOR EFFECTIVE ALZHEIMER’S COMMUNICATION

lzheimer’s disease presents many challenges, and communication is a big one. Despite the challenges, you can communicate effectively with a loved one who has Alzheimer’s. Consider these tips provided by the Mayo Clinic staff:

SPEAK CLEARLY Introduce yourself. Speak in a clear, straightforward manner. SHOW RESPECT Avoid secondary baby talk and diminutive phrases, such as “good girl.” Don’t assume that your loved one can’t understand you, and don’t talk about your loved one as if he or she weren’t there.

AVOID DISTRACTIONS Communication may be difficult—if not impossible—against a background of competing sights and sounds. KEEP IT SIMPLE Use short sentences and plain words. As the disease progresses, yes-no questions may work best, and only one question at a time is best. Break down requests into single steps.

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STAY PRESENT Maintain eye contact, and stay near your loved one so that he or she will know that you’re listening and trying to understand.

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DON’T INTERRUPT It may take longer than you expect for your loved one to process and respond. Avoid criticizing, hurrying and correcting. USE VISUAL CUES Sometimes gestures or other visual cues promote better understanding than words alone. Rather than simply asking if your loved one needs to use the toilet, for example, take him or her to the toilet and point to it.

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DON’T ARGUE Your loved one’s reasoning and judgment will decline over time. To spare anger and agitation, don’t argue with your loved one. STAY CALM Even when you’re frustrated, keep your voice gentle. Your nonverbal cues, including the tone of your voice, can send a clearer message than what you actually say.

When Alzheimer’s or dementia touches your life...

We’re here for you.

Scan the QR code or visit

alz.org/texascapital

for information and resources

Or call our free, 24/7 Helpline at

800.272.3900 Education and support programs are available in both English and Spanish. For topics, dates and registration links visit

bit.ly/alzcaptxedu

Map out a plan to approach Alzheimer’s alzheimersnavigator.org

Educational and dementia care resources alz.org/training

Online resources for caregivers alz.org/care

MID PHASE \\ MEMORY + DEMENTIA

SIGNS NOT TO IGNORE:

DEMENTIA VERSUS NORMAL AGING

f you’ve found yourself worried about whether or not a loved one might be showing signs of dementia, you aren’t alone. Distinguishing between dementia indicators and normal aging factors can be tricky, and it’s important to know the difference to avoid adding any unnecessary stress or worry to the situation. After all, is rushing mom off to the doctor because she called you your sibling’s name—maybe even the family dog’s name once…or twice—the right next step or even a cause for alarm?

DEMENTIA OR AGING: THE SIGNS

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The Alzheimer’s Society notes six different abilities and how they may be impacted by normal aging compared to possible changes due to dementia. We’ll cover all six and highlight a few of the differences between the impact of dementia or aging on those abilities.

1. SHORT TERM MEMORY & LEARNING NEW INFORMATION Normal aging can impact short-term memory and the learning process by causing one to falter or struggle to remember

something commonplace. Forgetting about an appointment or misplacing the phone are all traditionally normal occurrences for many as they age. Dementia can impact short-term memory in a bit more comprehensive way. Forgetting the names of loved ones or close friends or being unable to recall who you had lunch with earlier that day can be cause for added concern. Similarly, misplacing the phone or keys in illogical places, like the bathroom cabinet or freezer, may be signs worthy of more attention.

2. DECISION MAKING & PROBLEM SOLVING As we age, many people struggle to juggle multiple tasks at once, take a bit more time to process decisions or information, and occasionally make mistakes when completing everyday tasks. People who are impacted by dementia, however, might make

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frequent mistakes when completing tasks like cooking or cleaning, struggle to concentrate for very long, and get confused more often. If your loved one finds it difficult to comprehend finances or gauge the severity of everyday risk, these may be signs of a more serious issue.

3. LANGUAGE Struggling to remember the right word or keep up with a conversation where many people are talking at once is pretty normal for people of all ages, especially those who are older. Though if any of these things happen on a frequent basis, it could be a sign of dementia. Regularly referring to items using words like “that” or “this” may signal to you that something more serious is at play.

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4. ORIENTATION If your loved one occasionally needs to be reminded of the date or day of the week, this isn’t necessarily cause for worry. But if they struggle to recall what the season is or need daily reminders about the date, it may be time to address these issues. Another common characteristic of those impacted by dementia is feeling unsure of their surroundings when in an otherwise familiar place—like at home. 5. VISION & PERCEPTUAL SKILLS A common complaint among older adults is they have difficulty seeing as well as they used to, often impacted by cloudy vision or worsened eyesight. But struggling with depth perception when doing things like reaching for a door handle or climbing the stairs should be addressed by a doctor as these challenges go beyond the boundaries of worsened eyesight.

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WHEN IN DOUBT, TRUST THE PROFESSIONALS

As your loved ones age, it’s likely you’ll face challenges discerning whether or not their behavior is a symptom of something more drastic than old age, and that’s no easy task. While we often feel responsible for the well-being of those around us, remember it isn’t your job to diagnose them beyond your capabilities—unless, of course, you’re a neurologist. Not the case? Trust a professional to give your loved one the best care possible and address the needs that cause concern.

Take Five

Feel less stressed in minutes. Set a timer for 5 minutes and close your eyes. Take a few deep breaths releasing any tension in your body and imagining it melt away. Focus on a fivecount breath: • Slowly inhale from the belly • Then into ribs • Then into chest • Up into crown of the head • Then gently hold the breath for the fifth count On the exhale, reverse for another count of five. This time, start from the top of your head and move down to the chest, ribs, belly, pausing on that last bit of breath out of the body, and then repeat from the beginning.

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6. MOOD & BEHAVIOR Feeling stressed out or blue about life’s challenges or getting upset when plans don’t play out as expected is normal, especially as we age. If your loved one seems to become withdrawn or uninterested in their hobbies and friends, this could be a signal for greater concern. Similarly, being extremely sad or scared for seemingly no reason, or as a result of relatively ordinary challenges, could be related to dementia.

MID PHASE \\ NEW STEPS

CARE TRANSITIONS

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hen it comes to long-term care, people often use more than one solution over time. As people switch from one type of care to another, there is a transition period. A care transition may occur when someone leaves the hospital and needs support to heal at home after they’ve been discharged from the hospital, or it might happen when someone who is receiving in-home care decides to move into a supportive community, such as assisted living or senior housing. The goal is to avoid a gap in care for the individual as they pivot between different care types. When someone leaves the hospital or a rehab facility for home, their doctor or nurse can’t go with them, and a family or professional caregiver might be needed as they continue to heal at home. For example, someone might need help with using the bathroom, taking new medications, or going back to see the doctor for follow-up appointments. An even longer and different type of transition may occur when someone decides to move from their current residence to a

new one—whether that’s from a stand-alone home into a senior housing apartment, assisted living facility or in with family across town or another state. A caregiver—whether a family member or a professionallytrained one—can help to make these types of transitions smooth. If they’re transitioning to an assisted living facility, a caregiver can inquire about opportunities to join in meals and activities prior to moving in. This type of engagement can help the individual feel more relaxed about their new surroundings and making a big change. When making changes in long-term care options, aim for a continuity of care during the transition so risks for setbacks are minimized and chances for success are increased.

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MID PHASE \\ NEW STEPS

questions to ask

h w w o n K to ask

DURING HOSPITAL DISCHARGE

y asking the right questions and taking an active role in your loved one’s care, you can bridge the gap that patients typically experience when transferring from one care setting to another, which is one of the top causes for hospital readmission.

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What care or therapies are needed after discharge? i.e. home health, outpatient therapy, rehab/skilled nursing, etc. Will my loved one be safe at home upon discharge or will someone need to be with them 24 hours a day? Keep in mind dressing, bathing, cooking and housework. Can you show me how to do tasks that require special skills? i.e. changing a bandage, giving a shot, wheelchair transfers, etc. If we need help with these tasks, who do we contact? What is the average length of recovery time? Which doctor appointments are needed after discharge and when should they be scheduled?

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What problems, symptoms and side effects should we watch for? May we have the latest list of prescribed medications? What does each medicine do and why is it needed? What are the medication dosages, conflicts and side effects? Who should we contact with questions about the medications? What medical equipment is needed? i.e. walker, oxygen, etc. Who will arrange for this? Are there any activity restrictions and for how long? Are there any dietary restrictions? What are our options for when/where my loved one is being discharged?

My Questions

Jot down any questions or thoughts.

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MID PHASE \\ SENIOR LIVING

TYPES OF RESIDENTIAL CARE FOR SENIORS INDEPENDENT LIVING

ASSISTED LIVING COMMUNITIES

DESCRIPTION

Single family homes or townhomes for self-sufficient seniors that offer the security and social activities of a community living environment.

Communities, typically of 2-3 story apartments, that provide 24 hr assistance with activities of daily living such as eating, bathing, and using the bathroom, but not 24 hr medical services.

SERVICES

• Laundry/linen service • Meals • Transportation • Social activities

• Laundry/linen service • Meals • Transportation • Social activities • Bathing/Dressing • Toileting • Housekeeping • Medication assistance • Security and emergency calls

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NOTE – there are more luxury communities that have all the amenities of country clubs.

REGULATION

Not Regulated

State Regulations

ALSO KNOWN AS

Retirement Communities, Retirement Homes, Senior Apartments, Senior Housing, Senior Living Communities, Active Adult Communities

Assisted Living Facilities, Personal Care Homes, Eldercare Facilities, Domiciliary Care, Board and Care, Residential Care Facilities, Community-Based Retirement Facilities, Adult Living Facilities, Adult Foster Care, Sheltered Housing, Community Residences, Group Homes, Adult Family Homes

APPROXIMATE Market rate to rent or buy a COSTS home plus community fees from $700 – $6,000/month.

$2,844 – $9,266/month Avg cost in Texas is $3,795 – source Assisted Living Research Institute

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SKILLED NURSING (NURSING HOMES)

CONTINUING CARE RETIREMENT COMMUNITIES

Communities, typically private and shared rooms, which provide 24 hr assistance with activities of daily living and medical care by nurses and therapists.

Campus-like communities that provide a continuum of care, from private residences to assisted living and skilled nursing care; designed for individuals with declining conditions and those that want to remain in a single location.

• Laundry/linen service • Meals • Transportation • Social activities • Bathing/Dressing • Toileting • Housekeeping • Medication assistance • Security and emergency calls • 24 hr nursing care • Condition specific care • Hospice/end of life services • Doctors on call

State & Federal Regulations

Some State Regulations

Skilled Nursing Facilities, SNF, Nursing Home CCRCS, Continuing Care, Retirement Facilities, Care and Rehabilitation, Convalescent Life Care Facilities, Life Care Communities, Life Hospital, Rest Home Plan Community

$4,639 – $12,623/month

Varies with breadth of services required.

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Information courtesy of The American Elder Care Research Organization

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SENIOR LIVING \\ MID PHASE

SENIOR LIVING COMMUNITIES

in the Austin & San Antonio Areas MC 14390 Ranch Road 12, Wimberley IL 512-842-4152

AL Franklin Park Sonterra IL

18323 Sonterra Pl, San Antonio 210-404-1441

AL Franklin Park Alamo Heights

AL Franklin Park TPC Parkway

MC 230 W Sunset Rd, San Antonio IL 210-829-5955

MC 21802 Encino Commons, San Antonio IL 210-462-1004

AL Franklin Park Boerne

IL Lake Travis Independent Living

18 Old San Antonio Rd, MC Boerne 830-816-5150

Key

302 Medical Pkwy, Lakeway 737-377-0481

55+ Active 55+ Community SNF Skilled Nursing

IL Independent Living

AL Assisted Living

MC Memory Care

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AL Alexis Pointe

MID PHASE \\ SENIOR LIVING

AL Longleaf Bee Cave

AL The Crossing at Oak Hill Assisted Living & MC Memory Care

3936 S FM 620 Rd, MC Austin 512-648-3759

7501 U.S. Hwy 290 West, Austin 737-317-7906

55+ Solea Alamo Ranch 11133 Westwood Loop, San Antonio 210-981-5166

AL The Enclave at Cedar Park MC Senior Living IL

55+ Solea Cedar Park 1520 Juliette Way, Cedar Park 737-214-4130

3405 El Salido Pkwy, Cedar Park 737-260-3623

AL The Enclave at Round Rock Senior Living IL

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2351 Oakmont Dr, Round Rock 737-377-0473

Key

55+ Active 55+ Community SNF Skilled Nursing

IL Independent Living

AL Assisted Living

MC Memory Care

SENIOR LIVING

with Style

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Independent Living Assisted Living

Franklin Park® TPC Parkway 21802 Encino Commons San Antonio, TX 78259 (210) 462-1004 Independent Living Assisted Living - Memory Care

Independent Living Assisted Living - Memory Care

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Assisted Living - Memory Care Lic.# 147707

Lic.# 146061

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questions to ask

h w w o n K to ask

WHEN LOOKING FOR AN ASSISTED LIVING FACILITY

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tart with a visual assessment of both the inside and outside. Also, note if the residents are engaged in activities or just sitting. What is the staff-to-resident ratio during the day, at night and on weekends? What kind of experience and training does the staff possess? Is there an initial assessment prior to admission? If there is a waiting list, how many are on it and what is the policy? What are the billing and payment policies and procedures? Is there a security deposit and is it refundable?

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What and how much are additional services not included in the monthly fee? What additional services are available if resident’s needs change? What is the discharge policy? What off campus excursions are provided and how often? Are happy hour activities provided? Is Wi-Fi available and if so, where on the campus? Are there safety locks on the doors and windows? Is there an emergency generator or alternate power source? Are transportation services provided or a parking lot for the resident’s vehicle? What is the pet policy? Is rehab offered on campus? Can special dietary needs be accommodated? What is the meal program? Does the residence offer worship services?

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questions to ask

h w w o n K to ask

WHEN CONSIDERING SKILLED CARE

S 1

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tart with a visual assessment of both the inside and outside. Also, note if the residents are engaged in activities or just sitting. What is the staff-to-resident ratio during the day, at night and on weekends? Does the same team of nurses and certified nursing assistants (CNAs) work with the same resident all week? What happens when the Medicare reimbursement runs out? What amenities are private pay? Is Wi-Fi available and if so, where on the property? Are there safety locks on the doors and windows?

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Is there an emergency generator or alternate power source? What is the evacuation plan should it be necessary? What is the pet policy? Can special dietary needs be accommodated? Do residents have a choice of food items at each meal? Are the meals prepared on-site or off-site? What is the policy for residents eating in their rooms? Does the residence offer worship services? Is there a functioning security system? Are there pharmacy, lab, dental or x-ray services available on-site? Are they Medicare and/or Medicaid certified? Is abuse prevention training and background checks a requirement for all staff? How often are residents bathed? What special services can be provided if needed, such as on-site rehab, therapeutic whirlpool baths, ventilators, hospice, etc.?

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LATE PHASE

UNDERSTANDING HOSPICE

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ospice care is a philosophy of care that accepts dying as a natural part of life. When death is inevitable, hospice seeks neither to hasten nor postpone it. Hospice provides care, comfort and support for persons with life-limiting conditions as well as their families.

HOW DOES HOSPICE WORK? Hospice care is for any person who has a life-threatening or terminal illness. All hospices consider the patient and family together as the unit of care. Most reimbursement sources require a prognosis of six months or less if the illness runs its normal course. Patients with both cancer and non-cancer illnesses are eligible to receive hospice care. The majority of hospice patients are cared for in their own homes or the homes of a loved one. “Home” may also be broadly construed to include services provided in nursing homes or hospitals. Typically, a family member serves as the primary caregiver and when appropriate, helps make decisions for the hospice patient. Members of the hospice staff make regular visits to assess the patient and provide additional care or other services. Hospice staff is on call 24 hours a day, seven days a week. Whether paid for by Medicaid or private insurance, hospices will work with the person and their family to ensure needed services can be provided.

LATE PHASE

HOW IS HOSPICE PAID FOR? Hospice is paid for through the Medicare Hospice Benefit, Medicaid Hospice Benefit and private insurers. If a person doesn't have coverage through Medicare, Medicaid or a private insurance company, hospices will work with the person and their family to ensure needed services can be provided.

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WHO IS THE HOSPICE TEAM? Hospice care is a family-centered approach that includes, at a minimum, a team of doctors, nurses, social workers, counselors, and trained volunteers. They work together focusing on the patient’s needs; physical, psychological and spiritual. The goal is to help keep the patient as pain-free as possible until death. The hospice team develops a care plan that meets each patient’s individual needs for pain management and symptom control.

LATE PHASE

WHO IS ELIGIBLE FOR MEDICARE HOSPICE BENEFITS? Hospice care is covered under Medicare Part A (hospital insurance). You are eligible for Medicare hospice benefits when you meet all of the following conditions: • You are eligible for Medicare Part A (hospital insurance) • Your doctor and the hospice medical director certify that

you are terminally ill and probably have less than six months to live • You sign a statement choosing hospice care instead of routine Medicare covered benefits for your terminal illness • And you receive care from a Medicare-approved hospice program. Please note: Medicare will still pay for covered benefits for any health problems that aren’t related to your terminal illness.

WHAT DOES MEDICARE COVER? Medicare covers these hospice services and pays nearly all of their costs: • Doctor services and nursing care • Medical equipment (like wheelchairs or walkers) • Medical supplies (like bandages and catheters) • Drugs for symptom control and pain relief

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• Short-term hospital care, including respite and inpatient for

pain/symptom management • Home health aide and homemaker services • Physical, occupational and speech therapy • Social work services and dietary counseling • Grief support to help you and your family Please note: You will only have to pay part of the cost for outpatient drugs and inpatient respite care.

LATE PHASE

Hospice Resources

RESPITE CARE AND MEDICARE Respite care is care given to a hospice patient by another caregiver so that the usual caregiver can rest. As a hospice patient, you may have one person who takes care of you every day, like a family member. Sometimes your caregiver needs someone to take care of you for a short time while they do other things that need to be done. During a period of respite care, you might be cared for in a Medicare-approved facility, such as a hospice residential facility, hospital or nursing home.

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THE MEDICARE HOSPICE BENEFIT DOES NOT COVER THE FOLLOWING: • Caring Connections • Treatment intended to cure your caringinfo.org terminal illness. You should • Hospice Link talk with your doctor if you 1-800-331-1620 are thinking about potential • National Hospice and treatment to cure your illness. Palliative Care Helpline • Medications not directly related 1-800-658-8898 to your hospice diagnosis. • Texas and New Mexico Hospice Organization Hospice team members will 1-800-580-9270 consult with the hospice physician and will inform you and your family which drugs and/or medications are covered and which ones are not covered under the Medicare Hospice Benefit. • Room and board aren’t covered by Medicare. You may receive hospice services wherever you live, even in a nursing home, however, the Medicare Hospice Benefit does not pay for nursing home room and board.

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HOW DO I BEGIN RECEIVING HOSPICE? Anyone can inquire about hospice services. You or your loved one may call a local hospice and request services. The hospice staff will then contact your physician to determine if a referral to hospice is appropriate. Another way to inquire about hospice is to talk with your physician, and he or she can make a referral to hospice. Hospice can begin as soon as a referral is made by the person’s doctor. As a hospice patient, you always have the right to stop getting hospice care and receive the “traditional” Medicare coverage you had before electing hospice. All care that you receive for your illness must be given by your hospice team.

FIND HOSPICE CARE Halcyon Home Austin 8133 Mesa Dr., Ste. 200 Austin, TX 78759 512-815-9009

Halcyon Home San Marcos

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125 W. McCarty Lane San Marcos, TX 78666 512-667-6775

Hope Hospice 611 N Walnut Ave New Braunfels, TX 78130 1-800-499-7501

Hope Hospice of the Hill Country 29710 US Hwy 281, Ste 200 Bulverde, TX 78163 1-800-499-7501

OpusCare Texas Headquarters 2943 Mossrock Dr San Antonio, TX 78230 210-988-1461

Local options!

�OpusCare We can't change the destination, but we can affect

the journey.

TEAMWORK Our interdisciplinary team includes doctors, APRN, nurses, CNA, chaplains, case managers, social workers, bereavement counselors, volunteers, and more.

FOR MORE INFORMATION, PLEASE CALL OR VISIT

24-hour Phone Line: (210) 988-1461

WWW.OPUSCARE.ORG

San Antonio 2943 Mossrock Drive

San Antonio, TX 78230

Corpus Christi 3538 South Alameda Street Corpus Christi, TX 78411

The Valley IOI E. Expressway 83, Suite 200 McAllen, TC 7850l

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questions to ask

h w w o n K to ask

WHEN CHOOSING A HOSPICE PROGRAM

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1 2

3 4 5 6 7

What services are provided? What kind of support is available to the family/ caregiver? What roles do the attending physician and hospice play? How does hospice work to keep the patient comfortable? How are services provided after hours? How and where does hospice provide short-term inpatient care? Can hospice be brought into a nursing home or long-term care facility?

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Do physicians visit the patient in the home? What is the staff-to-patient ratio? Are any alternative therapies provided to manage symptoms? What extras does the hospice provide?

My Questions

Jot down any questions or thoughts.

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8 9 10 11 12

Are any of the staff members certified or credentialed in hospice?

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STEPS TO TAKE AFTER THE PASSING OF A LOVED ONE

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hen a loved one passes, it can often seem like the world has fallen off its axis. You no longer know which way is up or down, and while coping with grief, you’re forced to address pieces of their life that must be closed out. The process of taking care of final affairs after the death of a parent, spouse, friend or other loved one who you provided care for can seem overwhelming. We understand, which is why we’ve created a checklist outlining step by step what to do after someone passes, so you can spend more time focusing on healing. In the weeks following the death, you’ll want to begin closing out accounts and buttoning up any unfinished affairs. Tackle the tasks that are most meaningful for you and be comfortable delegating the rest to others.

STEPS TO TAKE WITHIN A FEW WEEKS: • Procure certified copies of the death certificate when it becomes available. You’ll need at least 10-15 copies to provide to entities such as banks and government agencies. • Find the will (if there is one) and figure out who the

executor is. This will be the person in charge of settling the estate in the days going forward, and they’ll need to be involved in all estate decisions hereafter.

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• As part of the financial steps

Probate

after the death of a loved one, A court-supervised contact necessary agencies proceeding designed such as a CPA (certified to officially prove a public accountant) and will’s validity estates attorney. These aren’t necessarily required, but they do smooth the process and make the legal side of things more manageable. • Take the will to probate so it can be executed appropriately. • Cancel any services that your loved one may have had, such

as magazine subscriptions, regular house deliveries, Netflix, Hulu, etc. You’ll also need to close out any credit card accounts and cancel their driver’s license so it can no longer be used. Make sure to also cancel any insurance services, such as home or car insurance. • Close out any remaining online accounts, such as social

Next Steps

There’s more of this article in our free Caregiver Toolkit. To discover more critical steps, visit srgtexas.com/caregivertoolkit

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media pages (these can be memorialized if you’d like) and email inboxes.

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PREPARING & PRESENTING A EULOGY By John B. Earthman

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he purpose of a eulogy is to acknowledge and share information about a person’s life. It’s a great honor for someone to present, and it’s an important part of the grieving process for the presenter, as well as the audience. A good place to start is to make a list of thoughts and memories you’d like to share. While others might not be comfortable or able to give their own eulogy, they might find great comfort in sharing memories with you that you could incorporate into the eulogy. Things you might include are stories, quotes, expressions of love or prayers—all of which can be delivered in a serious or humorous manner depending on what you feel is appropriate. In an effort to have the audience connected and involved in your tribute, the eulogy can be compiled from private memories that your audience might not be aware of, as well as personal traits and details of the loved one that all will remember. You’ll want to include any accomplishments or honors, no matter how big or small, that were especially important to your loved one. Memories shared should always acknowledge the person in a positive manner and recognize them for who they were accurately. Once you’re ready to write the eulogy, decide on how you’ll begin, then pick the main thoughts and memories that you wish to share and finally determine how you’ll close. You need to

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Remember

properly introduce yourself when you begin and have a summarizing statement to share when you close. You can read from your notes, but practice Nothing has to giving the eulogy and change make sense right any part that doesn’t feel like natural conversation in your now, you have time own words. to process what’s Presenting a eulogy can happening. cause great anxiety. Stopping at any time to collect your thoughts or emotions and then continuing when you’re ready is understandable and acceptable. If you decide that you can’t continue, simply skip to your final statement. It’s the message about the impact of your loved one that’s important, not the delivery, so just be yourself.

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Thoughts

Is there a story about your loved one you’d like to tell? Jot down any ideas, reminders or notes.

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7 items to consider when

PLANNING A CELEBRATION OF LIFE

eing in charge of planning your loved one’s end-of-life tribute is an important undertaking. How can you honor a person very dear to your heart— and the hearts of others—in a special way without it being a somber occasion? Hosting a celebration of life. This style of observance focuses on the joyous memories of how your beloved touched countless lives throughout their years. If you’re planning this type of celebration for your loved one who has recently passed, or you simply want to plan ahead for the future, here’s a list to ensure you check off all the boxes!

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1. CREATE AN INVITE LIST + DISTRIBUTE IT. Think of family, friends (new and old) and others in their life that they loved. Once the list is created, consider sending out the information via email, private Facebook event, printed invitation or phone call. 2. BOOK A VENUE. Choosing the right location can be challenging. Consider hosting the celebration at a park, faith-based community center or a place that held special meaning to your loved one. Then, decide if there’ll be a virtual aspect of the event to allow attendance from those who aren’t in close proximity to the location.

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3. SET A TIME. Will this take place during the week or on the weekend? Will it be in the evening after work or early in the afternoon? Pick a time that works best for you and your family and understand that it doesn’t have to take place right after the passing of your loved one. If you’re wanting to wait a few days, weeks, or months, that’s okay. 4. INCORPORATE PERSONAL TOUCHES. Adding features that are unique to your loved one will make the celebration even more memorable. This could be having a special theme such as a luau because they loved Hawaii or wearing purple because it was their favorite color. The number of ideas is endless, and the sentimental factor will touch everyone in attendance. 5. DESIGNATE SPEAKERS. Asking a few people to share stories about your loved one is the focal point of the celebration. After all, storytelling can be the best way to make everyone feel connected. Encourage opening the floor to others once the designated speakers are done.

7. GATHER PHOTOS AND CREATE A SLIDESHOW. Sharing a slideshow of images and videos of your loved one can be impactful. Pull together the memories with family and friends and have your loved one’s favorite songs playing in the slideshow background. Remember, it’s a celebration for your loved one. Share wholesome experiences, laugh at funny stories and cry if you need to. Don’t hold back your emotions; be comforted knowing that your loved one is leaving this world with a beautiful commemoration.

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6. SERVE REFRESHMENTS. You don’t have to provide an entire meal; however, serving some appetizers and drinks is appreciated. Whether you choose to do this buffet or potluck style, create a spread that fits within your budget. Also consider offering alternative options for those with dietary restrictions.

When it comes to home care, not all providers are created equal.

Use the Senior Resource Guide’s Home Care Comparison Chart and online Care Directory to find the provider that’s right for your loved one. SRGTEXAS.COM/HOME-CARE

DELIVERING MORE THAN A MEAL Meals on Wheels San Antonio prepares and delivers nourishing meals, friendly visits and safety checks to older and disabled individuals in Bexar County and the surrounding area.

“You know when I ask for help, I ask because I need it, not because I want it.”

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