Caregiver Archives 2010
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  • Ruth Miller
  • Gift Ideas for those in Nursing Homes
  • Visiting Hour (poem) by Josephine Miles
  • Wish You Were Here by Gwendolyn de Geest RN
  • Medications and the Elderly by Pat Gates
  • Why Should I Care About Your Problems? by Paul R. Blake
  • It's All In the Attitude by Suzanne Mintz
  • Components of a Condolence Letter
  • Helen Keller on Friendship
  • Normal Negative Feelings a Caregiver May Have
  • Ways to Save on Prescription Drugs
  • Should I Split My Pills?
  • Bear Infirmities of Weak, Not to Please Ourselves
  • Short poem on Friendship
  • What a Friend We Have in Jesus (hymn)
  • Friendship

As a way of introduction, my name is Ruth Miller and I have been reading "ourhopeonline" for a long time and have actually contributed bits and pieces of information along the way.  My life has been encouraged and uplifted by so many of the articles that have been published in this newsletter, and for that, my hat goes off to all of those who work the never-ending hours it takes to get this online newsletter published.

My history starts with being raised in a very strong and stict Catholic family. I took my spiritual life very serious, even as a young child.  I went to catholic school and attended Mass nearly every time it was "offered".  I even played the Virgin Mary in the Christmas play one year, which was an esteemed honor. It was only after meeting in high school, my husband of 47 years now, that I was led into the truth. In the beginning, my life was like riding a roller coaster for a long period of time after being introduced to the truth.  At this time, I was still in high school and living with my family.  There were many times of confusion, argument, aggravation, frustration, depression and soul-searching before emerging as a Christian woman . . . but I have no complaints. I feel God has blessed me so abundantly by allowing me to meet Leon and having him teach me the truth.

In fact, I have a brother and sister older than me and a brother and sister younger than me (and yes, that puts me as a "middle child syndrome"), and NONE will give me even the time of day when it comes to discussing their spirituality.  Over all these years, there has been a wall between us in this regard and it put me in the "black sheep of the family" personna.

Because of the above, I am in the process of writing my autobiography, not because my life has been so spectacular in and of itself, but because this book will include the pros and cons (heartache, separation from family, adjusting lifetime patterns, learning and retraining your thoughts, getting used to the mind-shattering idea that all of your spirituality prior to that point was to no avail, etc.), that will literally smack you in the face when becoming a Christian, especially for a Catholic, let alone a strong Catholic.  While my family will not pick up a bible (if they even have one), they will read my story, even if just out of curiosity, and this will include all the information they need to become a Christian.  My hopes are that they will read this with an open mind and follow through on this as I did. This will be my last ray of hope to reach them spiritually, and if they do not respond, my thoughts will be like those of the apostle Paul and will shake the dust off my feet and go onward.

Another of my favorite pastimes is writing poetry and my thoughts always try to reflect something spiritual in every poem I write.  However, my time to write is limited as my care giving responsibilities take priority.  My Aunt June has been a responsibility for us for 23 years.  She was mildly retarded since birth, had cognitive brain syndrome and the mentality of an 8-year-old; along with this came a low-boiling-point temper and a strong independent mind of her own with a very warped sense of right and wrong. Additionally, my mother-in-law has lived with us for over five years, having had a near-death traumatic illness.

Both were living with us on a permanent basis until a year or so ago when we had to place June in an ALF due to combativeness and the fear she would hurt Edith in some way should we both be away for a short period of time. Both of my little ladies are 88 years old and have no short-term memory combined with progressive dementia to one degree or another. Anyone who has ever been a care giver knows how many times you will bite your tongue and the "ridges" you develop over the years with long-term care giving.  It is a very humbling revelation as well as a very frustrating experience as time progresses; it is sad to see the deterioration that continues until there is nothing left to deteriorate.

Care giving on this level, while very restrictive to our personal lives, has helped me to realize, should my life be extended this long, that I too would want someone to care for me as I am caring for them; this helps me to remain focused and on a level plane with my current responsibilities as a care giver. The other day someone asked my how I managed this for so many years and it took me a while to consider my answer because I did not know how I managed.  Looking back on the time when Edith first came to live with us, she was close to being a vegetable as far as her functional level at that time and she alone was a full-time job for many months.  I searched and asked myself the same question, but I realized immediately that the answer was right there in front of me. . . if my life did not include a strong faith, my abilities to cope would be severely limited and I could not have done this without God's help.  It is an all-consuming job and there are numerous ups and downs that arise on a daily basis.  I find myself praying continually for patience, compassion and a good attitude so that I don't fall into being resentful at having to do this since before my children were grown.  We have two children and five grandchildren and they call our home "Miller Manor" . . . and my response to them is, "yes, and there is no more room at the Inn."  We have learned to laugh at ourselves and at life . . . otherwise, we could become embittered if we let this get to us.

All this aside, my life has been very fulfilling even though we desperately long for the time when we too will get to experience the "empty nest syndrome".  Nevertheless, we both know that God is in control.  My philosophy of life since I was a teenager is that there is a reason for everything to happen as it does, whether we know the reason or never know the reason, and this has been proven true so many times during my lifetime.  We just have to remember the dark times build us and strengthen us for whatever may appear in the future.

My husband is a Systems Technologist over the southeastern portion of the US with Motorola and I do medical transcription at home.  We both plan to retire soon and hope we will have a time, at some point, where there will be just the two of us, to share in doing some of the things we have always wanted to do but never could.  God has abundantly blessed us in other ways, as if compensating us for the loss of the "best years of our life" given up to care giving.  Nevertheless, we both learned a long time ago that when life gives us a lemon, as the saying goes, we make great lemonade!

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GIFT IDEAS FOR PEOPLE IN NURSING HOMES
  • Personalized cards for birthdays, Christmas, or just Thinking of You -- personally delivered.
    Pretty little doo-dads for ladies
  • Snacks, as permitted. I know who likes what and try to carry a bag with a variety to give out.
  • Hats. Ladies and men like them. I do fishing hats for the men.
  • Handshakes. People like being greeted as if they're human beings rather than patients.
  • Compliments. I tell all the ladies how pretty they look and try to compliment them on something specific -- a new haircut, a pretty shirt. You can tell the men how dashing or spiffy they're looking.
  • Stuffed animals. You'd be surprised at the people who end up loving them.
  • Videos on topics of specific interest to a resident.
  • The following ideas involve your time, which is more important than anything else to nursing home residents.
  • Games. Play cards, hangman, tic-tac-toe, checkers, even charades... whatever games the person likes.
  • Reading. My husband loves to be read to.
  • 20 questions. Arm yourself with questions to ask and give the person lots of time to talk. Questions about his.her experiences are always winners.
  • Grooming. ladies like to have their nails done. Light massages are nice. Just slowly brushing someone's hair is much-needed attention and physical contact.
  • Music. If you play an instrument, try doing it room by room for those who are room-bound. There's a lady who does this at my husband's NH and the residents just love it.
  • Playing ball. Men especailly love tossing a ball back and forth.
  • In nice weather, rides outside in wheelchairs. In poor weather, do it inside. Stop to talk to others, look at and talk about bulletin boards and decorations, read menus, etc.
  • Pet visits. Check the NH's policy, but residents just love, love, love visits from puppies and rabbits.
  • Deliver and read mail. Talk to recreation directors.
  • Art. Take a child-size easel on wheels and some water paints. Anyone who can hold a paint brush can create something.
  • See what sort of games and equipment the rec department has. They often have stuff they've forgotten about that you can put to use.
  • Finally, one thing I see residents eat up is just being around other people having normal conversations. Invite a few people at once and just hang out in rooms gabbing. The resident may not participate but he'll still love it. it makes him feel connected to the real world and included among regular people.
  • I have been making lap afghans to contribute to a local nursing home. Some elderly people get cold sitting in wheel chairs and I find that if I make them about 40 in. square, it's just the right size to cover legs. No fringe, because it might tangel in the wheels. also they love magazines that in good condition, no matter the subject.
  • Nursing homes lose socks and clothing. ( go to yard sales and get good ones for 10/ 25 cents,wash and dry) They love visits. Maybe you can find some friends to go with you sometimes. They like pocket packs of tissues, small stuffed animals,ceramic cups & bud vases with a real flower to smell. (10 cents at yard sales)Yard sale beads/dress pins,ask at yard sales if they would like to donate anything to the cause, like music boxes or small figurines. Read to those whose eyesight has gone.Some will not want anything from you. Don't be discouraged dear. Lots more will love your visits. Be sure to ask first if they can have cookies/Brownies. Some can and they would like to have homemade,now that Splenda ( sugar free) is available to use in baking you would be doing a great service to the ones that are diabetic.
  • By far the best thing you can do is visit and talk and spend time with the nursing home residents. I'm sure you know that already. Any break in routine or new activity would be great, and since you're crafty! Off the top of my head: cards are a great idea. You could perhaps make do a mini card-making project with the folks there. Scrounge up and bring in whatever stationary supplies you can find (paper, glue-stick, fancy pens, envelopes, stickers, scissors, etc...) and organize an afternoon project--have people create a personal card (or even a postcard) to send to someone he or she loves and misses.
  • Socks with non-slip soles, sweatsuits, hand lotion, deoderant, crochet and quilted lap robes. Contact the staff Social Worker before going to find out the best time to go and what to bring. Adopt 1 or 2 residents that have no family or friends and never have visitors. Send them birthday cards and special occasions cards. Make a commitment to visit on a certain day - like every Tuesday - and honor your commitment. Life its so much brighter when you have something to look forward to. I worked as a social worker in a NHO and it is so sad to see all the attention at Xmas time and then the rest of the year the residents have no visits or gifts.

http://www.thriftyfun.com

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                 Visiting Hour

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He sat in an easy chair by the open window,

Leaning back with his legs crossed.

Someone sitting on the bed was intently speaking,

And he listened intently, answering softly.

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The eastern hill of houses outside his window

Flung back the sunset light into his evening,

And the smoky shadow gathered

From inside to out.

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When the one who had spoken picked up her gloves and left him,

Patting his shoulder,

He came to the door of the room with her

And kissed her softly.

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Then he went back to the dark sill of the window

And knelt there, head on his arms, sometimes

Softly lifting his head to look at the view, and then dropping it,

Beating it with his fists.

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By Josephine Miles

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Wish You Were Here
By Gwendolyn de Geest RN, BSN, MA

I am sitting in the restaurant having lunch with my husband, Howard. But Howard's not here..

     We ordered our lunch; Minestrone soup (Howard's favorite), Caesar salad, a nice panini bread, and tea. Howard excused himself, "I have to go to the bathroom Dear."    

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    "Alright," I responded. The soup came; I didn't want to start without Howard, but I was hungry. I finished my soup, still no sign of my husband. The salads arrived, still no Howard. The food items have taken on a secondary importance.    

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    By now, I'm beginning to wonder. I asked our waiter, "Excuse me, would you please check on my husband? He's been in the men's room for a very long time."    

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   The young man complied, and reported back to me, "Your husband says to tell you that he has to wait for his friend. In fact, the two of them are engaged in conversation."  

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  "I don't understand," I replied. "Howard went to the bathroom alone."  

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   By now, the young man could see that I was becoming anxious. With a sigh, he said, "Okay, Madam, I'll check on him once again if you like."   

   And he did so. When he reported back to me, it was the most confusing and frightening message I have ever received.    

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  "Your husband is talking to his friend in the mirror. He told me to tell you he can't join you for lunch until his friend is ready."

♥  ♥  ♥  ♥

 

    Peggy and Howard met nearly 45 years ago at a University dance. Peggy was studying Nursing, and Howard, Civil Engineering. Peggy said, "I knew I was going to marry that guy, when he offered to take me home from the dance, with a bus ticket he found on the dance floor." They married three years later; two children followed, a son and a daughter. 

    "Wish You Were Here" is a true story. Howard is in early stage Alzheimer's disease. From the moment of diagnosis, his wife, Peggy, family members and friends are thrown into a state of turmoil, attempting to understand and attach meaning to what is happening to this person, Howard, they once knew.

    Alzheimer's disease has no known cause. Alzheimer's disease has no known cure. In 1906, Dr, Alois Alzheimer cared for and documented evidence on Auguste D., a fifty-one year old woman in Frankfurt, Germany. Even he didn't know for sure until he examined the slice of brain tissue under the microscope, identifying the plaques and tangles surrounding the neurons, hallmarking the disease process. This was the very first step in searching for the cure. However, families don’t know for sure it is Alzheimer's disease until autopsy.

     There is absolutely nothing uplifting about any of this information for family members and friends caring for a loved one with Alzheimer's disease. They don't understand what is happening. There is a lot of chaos and confusion as they attempt to deal with the activities of daily living and restore once again some form of normalcy to their lives. 

.. The interview with Peggy, the wife follows:

Talk about how it was for you when Howard was diagnosed with Alzheimer's disease.

The first thought I had was fear, but then, as strange as this may sound, the diagnosis almost came as a relief. I now can understand what has been causing Howard's strange behavior. And, to empathize with some of his fears.

Can you offer suggestions for other families who are passing through a similar journey?

The scary part of Alzheimer's disease is I don't know from one day to the next how Howard is going to react to different things. He said to me one day, 'Peg, I can't remember from one minute to the next what I've done and what I haven't done.'

What has really been most helpful is to draw closer with family and friends. We always have been a close knit family and now I feel the children are even closer. I feel blessed to have them. The best thing for us has been to take one day at a time. Some days, Howard is really himself again, and this gives me hope.

 Do you communicate with Howard any differently since the diagnosis of Alzheimer's disease?

After 39 years of marriage, Howard and I are sensitive to one another's body language. I know when Howard is happy, sad, glad, mad. I don't talk to him any differently, but I find Howard now communicates with feelings, not words. This happened when we were in the restaurant that day. Howard seemed to be getting agitated as soon as we arrived and needed to excuse himself.

Are there times you have difficulty understanding what Howard is saying?

I find I must be real sensitive to his body language and anticipate his needs. One day Howard wanted a glass of water and couldn't articulate the word glass. This frustrated him a great deal. We played guessing games for a bit until I figured it out. Even that day in the restaurant, he was trying to tell me he didn't want to be there.

How do you make the transition from being the wife of Howard to being his caregiver?

It's difficult. This disease is not about me. I know that, and yet some days I feel, 'hey, my needs aren't being met.' Howard and I have always been very close, and we still are. Alzheimer's disease has changed our lives, but Howard is still Howard and I love him, whatever my role is. I will always be here for him.

What made you choose this particular restaurant to have lunch?

I have been told that the person with Alzheimer's disease needs an environment that is non-threatening, familiar, and simplified. Howard and I have been to this restaurant many times. This visit, he no longer recognized the place or the waiter. I guess that means we are onto the next stage.

Do you find that social situations have become awkward?

Howard and I never have been social butterflies. We have a small circle of friends. However, I do find that we stay at home more now. That day in the restaurant was awkward; I guess because the 'mirror dilemma' was so shocking for me. I had a difficult time encouraging Howard to get to the car. He didn't even eat his lunch.

How did you manage to get Howard to the car?

Good question. As hard as I try not to be embarrassed or humiliated by these 'public scenes,' I am. I know that Howard doesn't function well with noise or outside distractions. I really should have been more sensitive to his body language at that moment. The waiter was terrific and so helpful in encouraging Howard to 'excuse himself from his friend,' and return to the table.

On the car ride home, we found humor in the situation. I find that it works really well to change the subject

Talk about some things in your home environment that you have changed?

Howard is down to basics. I have simplified the environment as much as possible. I find that this eliminates a lot of confusion for him. The fact that Howard was engaged in conversation with 'a friend in the mirror' is an indicator that he no longer recognizes himself or others around him. Interesting that Howard isn't bothered by the mirrors in our home.

When do you pause in your busy day to take care of Peggy?

I only give Howard so much of my time. I take good care of me. I maintain a healthy diet for both of us and we take walks together. I love that Howard still likes to hold hands when we are walking.

Howard loves to garden; he finds great joy in pruning the shrubs. I join him outside and we both enjoy the fresh air and nature.

Talk about how Alzheimer's disease has changed your family relationship and interactions with your children and grandchildren.

The children focus on Howard, their Dad and their Grampa, and not the tragedy of Alzheimer's disease. Some days, Howard doesn't remember our children's names. This hurts. Never mind; we keep our love strong and our family strong. I do try to keep family gatherings smaller now; Howard enjoys this much more.

What lessons have you learned from caring for your husband?

Alzheimer's disease has robbed Howard of our memories. However, one can still be someone without memories. We can still have a life without our memories.

Howard is lacking in judgment. The other day, he had his best suit jacket on to go out and wash the car. I have resolved that if the behavior isn’t hurting him or others, then I let it go.

Howard gets upset with me when I try to do too much for him. So, I focus on what he still does really well. Howard makes a dynamite pasta sauce, and when we work together in the kitchen, I make sure that I chop the veggies.

I find that Howard lives in the moment. I know that Howard is still in there. And I know Howard is still a beautiful human being.

http://www.aging-parents-and-elder-care.com

Gwendolyn de Geest, RN, BSN, MA, is the author of "Wish You Were Here." She has been working in dementia care for over two decades and has witnessed the joys and sorrows of families struggling to maintain a quality of life for themselves and their loved ones. Gwendolyn's thesis, "The Relation Between the Perceived Role of Family and the Behavior of the Person with Dementia" is published in the American Journal of Alzheimer’s Disease, May/June, 2003. This work was presented at The International Congress of Gerontology, Vancouver, Canada. Gwendolyn resides in Vancouver with her family where she is a professor.

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Medications and the Elderly ~ What You Should Know to Prevent Problems

Pat Gates

Last year my mom developed dementia. Because she has Parkinson's disease we thought perhaps it was part of the disease process or maybe it was lewey body dementia. Whatever the cause, she was getting worse, almost to the point of not recognizing her own children and grandchildren. She hallucinated, often not knowing if it was day or night, she had little appetite, and she would spend most of her days sleeping. Her Bible would sit beside her untouched and if anyone knows my mom, they know something's seriously wrong as she reads several chapters every day.

At the assisted living facility my mom lived at, a hospice nurse controlled what medications she took and this nurse was the one who would recommend any new medications she thought she needed. Because of Parkinson's, the nurse gave her a medication for drooling. When they called to tell me, I told them not to give her any medication without checking with her neurologist; it was done anyway. Because the medication gave her such relief from drooling and everything looked fine I figured it was OK.

As time went on the family began to see more forgetfulness and confusion until finally it reached actual hallucinations - seeing objects that weren't there and talking to people that only she could see. At times mom would get scared because she knew something was wrong but she didn't know what - hospice's answer to that was to give her vicodin with any pain or anxiety she had. Of course that contributed to her sleeping too much and beginnings of depression. I complained to hospice about mom being over-medicated with vicodin (she was not in any great pain and she was not end-stage disease). A week later the hospice nurse discharged her from the facility (yes, she had power to do so). I am not judging all hospice organizations by this woman, as we had hospice care for my dad a few years earlier, I do judge this one nurse as being incompetent in handling my mother's case.

The day after the nurse discharged my mother to a nursing home, this same nurse sent my mom to the hospital due to very low blood pressure. Again, it was medication. I had told them to be careful with blood pressure medicines and to be vigilant with checking her pressure first as she had trouble in the past with blood pressure falling too low. I told them in the hospital to please check her blood pressure and try and figure out the correct dosage of medicine she should take. This was ignored.

Mom's dementia was increasingly getting worse and we were convinced we had lost our mother to this brain disease. She had gotten to the point she was unable to do anything for herself, even needing help at mealtime. She had been placed in a nursing home down the road from my house. As her children and grandchildren were adjusting to this sad news, mom began to get better. In a short period of time mom was back to herself! Amazing!

A month or so ago I was with mom and her drooling was so bad, she had to constantly wipe, which was very irritating to her skin as well as tiring. I couldn't understand why the nursing home had taken away her Atropine (for drooling) and I spoke with the nurse and asked her if she could talk to the doctor and put her back on it. Three days later I received a call from my mom. She sounded upset and she told me she didn't want to worry me but my son was in her room, looking very sick and not talking. My son was in Atlanta and could not have been in her room and immediately I knew why she was hallucinating - the Atropine. I went right to the facility and had the medication stopped. They did it right away and the next day she was normal, not even remembering the hallucinations she had the previous day.

So months after the beginnings of dementia, we found out it was not caused by disease but from medication. Mom had been in the hospital 3 times with the dementia and had been seen by several doctors and none of them questioned medication even though the dementia had come on rather rapidly.

I have learned from this that our elderly parents need us to be informed in order to be an advocate in their daily care. Too often we trust doctors and Hospice workers in the decisions they make, but they are human and can make errors in ignorance. When I had mentioned to friends about the disappointment in the hospice care my mom received, they would get defensive as they didn't like me saying anything bad about Hospice. I, too, had hospice come out to the house to care for my dad and he received good care at home and I greatly appreciated their help. However, no organization is perfect and we need to keep an eye on anyone who is handling medications for our loved ones. And we need to double-check ourselves if we are the ones giving the medications and make sure we are giving the correct dosage. We need to inform our parent's doctors about ALL medications they are taking and not mix herbs and vitamins with them without checking on any interactions that might occur between the two. Also, it's important to find out if the medications can be taken at the same time, with or without food, and the time of day they should be taken as some may interfere with sleep. And always discuss medicine change with the doctor as he/she needs to determine if it is the medication or disease that is the cause for any new symptoms.

"When I was in training, my mentor taught me the maxim that any new symptom in an older person should be considered a drug side effect until proven otherwise," Jerry Gurwitz MD

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Here are some suggestions to make sure our elderly parents aren't being overly drugged:

1. Research each medication and be familiar with the side effects, especially in the elderly population. Click here and here for a list of drugs that often cause problems for older people. However, this list is not exhaustive (Atropine isn't listed). Don't stop the medication if you see it on the list without talking to a doctor, unless a serious allergy is occurring and then you need to call the doctor right away. Not all patients react in the same way to medications so discuss any concerns you may have with the doctor.

2. Older people metabolize drugs differently from younger people (unless the younger person has liver and kidney problems). In the elderly, the liver and kidneys may not easily process medications, and changes in the fat and muscle distribution of older people make them more susceptible to drug problems, according to American Society of Consultant Pharmacists.

The body regards these chemicals as foreign substances and tries to rid itself of them. This is commonly done by elimination through the kidneys, by metabolism in the liver, by utilization and uptake in the body tissues being treated or by absorption in body tissues such as fat cells. If not enough medication is provided to the cells that are to be treated for a condition, the medication may not have its intended effect. If too much medication is circulating in the bloodstream there may be unintended side effects such as dizziness, confusion, memory loss, cell damage, retention of fluids, hypertension or hypotension, dehydration, stroke or other brain damage, cardiovascular disease, internal bleeding, heart rhythm problems and sometimes even death. The medication may produce much more harm than the condition it is treating. http://www.longtermcarelink.net/eldercare/medical_care_issues.htm#medications

3. Drugs may interact with each other. Some very common drugs don't mix well in the elderly, according to Dr. Robert Epstein, chief medical officer at Medco. For example, he says, anti-anxiety medications and sleeping pills can cause dizziness and falls, blood thinner and aspirin can make the blood too thin, and beta agonists for lung issues and beta blockers for cardiovascular issues can cancel each other out.

4. Have the doctor review the medications on a regular basis. This is especially important if your parent is seeing different doctors because often they don't consult each other before prescribing a drug. Ask them if any drug will interfere with the effectiveness of the other drugs and is it ok to take them at the same time.

5. Get your pharmacist to review your medications. It's been my experience that, unless the pharmacist is too busy, he/she gladly welcomes questions.

6. Ask your doctor: Do I really need this medication? Sometimes doctors are too free with handing out medications but it's not always their fault; some patients feel they have not received adequate care unless they leave the doctor's office with a prescription in their hand. Drugs aren't always the answer and doctors may be giving you the best care not giving you a new medication.

7. Be sure the medication is taken as prescribed. Medications are sometimes time-released and giving the next dosage too soon may result in overdose. If a medication seems to be helping, don't take twice the amount thinking that the more the better. Years ago I had someone tell me they took double the dosage of digoxin because they felt so much better that they figured if they took more they'd feel even better. If you are familiar with digoxin you will know what a dangerous thought this was as it could have created severe, life-threatening consequences if overdosed. Also, don't go the opposite extreme that the medicine made your loved one better so you can stop it and all will be fine. Check with the doctor first.

8. If the doctor has given your parents an on-going prescription, now and then ask if they need to still be on that medication. Unfortunately, doctors don't always review the long-term medications with the changes the body goes through month by month or year by year. Sometimes the dosage may need to be lowered or raised.

9. If your elderly parent insist on fixing their own medicines ask them if they'll explain to you what they use and how they take it just in case you need to know in the future. Double check them with the directions on the bottle to make sure they are doing it properly. If memory problems or dementia is becoming a problem you may have to insist on taking control of their medications if you believe they could harm themselves by over-dosage or under-dosage. Insist with love and kindness remembering how difficult it must be to lose power in your own decision-making.

10. If your parent is in an assisted living or nursing facility, now and then, ask for a print out of the medications they are taking and check and see if a new one has been added. If so, be sure you understand why it was added and watch for any side effects that may go unnoticed by the staff.

11. Use one pharmacy for your parent's medications. Pharmacists or the computer program the pharmacist uses will alert the patient of any drug interactions or allergies to an ingredient in the drug. If using different pharmacies, one may not have the correct information in their computer.

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Why Should I Care About Your Problems?

Paul R. Blake

The story is told of a mouse with a problem. The farmer had placed several mousetraps around the barn hoping to rid his farm of a rodent. The nearsighted mouse was very concerned about this. He was afraid that he might stumble into one of the traps by mistake or that one of his children might get caught without realizing the danger they were in. He asked the chicken, the pig, the cow, and the horse to help him destroy the traps. The chicken replied, “I have no trouble avoiding the traps, and I have no interest in the bait. The traps are your problem; why should I care about your problem?” The pig replied, “My hide is thick and the traps will not hurt me; besides, the bait is too small to interest me. Why should I care about your problem?” The cow and the horse expressed their disinterest, “While we could trample the traps into splinters, the needs of little mice hold no interest for important farm creatures like us. Why should we care about your problem?”

That night, a snake entered the barn and was accidentally caught by the tail in one of the mousetraps. The farmer found the snake in the trap and was bitten when he attempted to remove it. He became very ill, and so the farmer’s wife killed the hen to prepare him some chicken soup. However, he did not seem to recover and had to hire temporary help care for his farm. He ordered the hog to be butchered to feed the farm hands. Sadly, the farmer died from the snakebite, and the grieving wife had the cow slaughtered to feed the many mourners who came to pay their respects. Finally, the horse had to be sold to a dog food company to be processed in order to pay for the mortician’s services. The mouse’s problem was everyone’s problem.

“Why should I care about your problems?” It’s not a cynical question. Multitudes of conscientious folks overwhelmed with busy lives have to decide on a daily basis, not just how many of their own problems they can juggle, but whether it is possible to help others with their problems. In order to crowd another trouble into an already packed schedule, they have to have a good reason to motivate them to make the necessary sacrifice. It is so easy to slide into the habit of responding with the belief that they will not be impacted by the other person’s problem, and therefore withhold any offer of help.

In truth, we cannot know all outcomes; only God can know the results of every matter in this world. We often deal with the byproducts of others’ difficulties. The church at Corinth was harmed by the influence of one fornicator (1 Corinthians 5:1-6). The church at Jerusalem was troubled by the neglect of the Grecian widows (Acts 6:1). Peter’s error at Antioch led the Hebrew Christians and Barnabas astray (Galatians 2:11-13).

Looking out for one another’s well being is part of Christ’s will for His disciples. “Bear one another's burdens, and so fulfill the law of Christ” (Galatians 6:2). “Let nothing be done through selfish ambition or conceit, but in lowliness of mind let each esteem others better than himself. Let each of you look out not only for his own interests, but also for the interests of others” (Philippians 2:3-4). Your brother’s problems are your problems.

Sharing our blessings with those who are in need is a necessary manifestation of the love of God. “But whoever has this world's goods, and sees his brother in need, and shuts up his heart from him, how does the love of God abide in him?” (1 John 3:17). Your brother’s needs are your needs.

It is vital that Christians remain aware of how others are feeling. How one feels today often determines what he does (or does not do) tomorrow. “Rejoice with those who rejoice, and weep with those who weep. Be of the same mind toward one another” (Romans 12:15-16). Your brother’s highs and lows are your own, and they will lead to actions that can help or hurt, not just the individual, but all those with whom they interact.

Christians are not islands. They are part of a local congregation of Christians that are affected by what each other says and does. Not only have they no right to say, “It’s my life; I’ll do with it what I want,” we have no right to say, “It’s their problem; why should I care about their troubles?” We need each other. God put Christians together in groups called churches in order that they might look out of each other and offer help as needed. We fulfill one of God’s designs for the local church when we help our brother bear his burdens. “But now indeed there are many members, yet one body. And the eye cannot say to the hand, I have no need of you; nor again the head to the feet, I have no need of you. No, much rather, those members of the body which seem to be weaker are necessary... that there should be no schism in the body, but that the members should have the same care for one another. And if one member suffers, all the members suffer with it; or if one member is honored, all the members rejoice with it” (1 Corinthians 12:20-22, 25-26). Why should I care about my brother’s problems? Because his problems are my problems, too.

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It's All in the Attitude

Attitude impacts action. Our inner thoughts propel our outward actions. Sometimes the way we approach any given situation is based upon our perspective of it. We can ignore the rainbow after the rainstorm or choose to bask in all its luminous glory. One example of insightful change of perception is exhibited in the following story:

The following poem was written by a family caregiver after her husband got his first wheelchair. This was actually the second poem she wrote on the subject. The first was very dark. It reflected all her mixed emotions and fears about the future. She ripped it up and then wrote this one.

The Chair - A poem abut the Power of Positive Thinking

It sits there at the crest of the beach, on the rise just before the

sand dips towards the water's edge.

A long beach chair, seemingly abandoned.

It's a jaunty chair with its yellow stiped canvas seat and

sailboats floating on its blue and yellow back support.

It lists just a bit to the left, almost rakishly,

as it nestles in the sand, surverying the sea.

It is a chair made just for sitting, and sitting on the sand at that.

It has no legs to get in the way of stretching out, relaxing,

and letting the sun seep into your bones and warm your soul.

It is so unlike another chair I know. A black chair with wheels.

A chair that does not survey the vastness of the ocean with a jaunty air,

but rather a chair that defines a narrower kingdom.

And yet, I think this other chair is a happier chair than the one that

sits and stares out to sea, for it is a chair with wheels that take the

place of legs no longer able to propel their owner forth.

This other chair is not made for sitting and looking at the world.

It is a chair built for exploring, for meeting life face to face

and tasting of its spirit.

Perhaps this chair should have a seat of yellow and white stripes,

and a back support adorned with sailboats.

A far better statement of its adventurous and joyous possibilities.

-Suzanne Mintz

http://www.nfcacares.org

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We are all caregivers to those who are grieving. Sending a sympathy card is one way to show your care, but it's not always easy to know the right words to say to the one who is feeling the great pain of loss. Here is a helpful article I copied off the internet to help us know the best way to write a condolence letter/note.

Components of a Condolence Letter

There are seven main components you may want to include in your letter:

  1. Acknowledge the loss and refer to the deceased by name.
  2. Express your sympathy.
  3. Note any special qualities of the deceased that come to mind.
  4. Include your favorite memory of the deceased.
  5. Remind the bereaved of their personal strengths or special qualities.
  6. Offer help, but make sure it is a specific offer. Instead of “Let me know if I can help with anything at all,” try something like “I know that Phil took you to church every Sunday. Let me take over that duty for awhile. I’ll pick you up on Sunday at 8:30 a.m.”
    More ideas to
    Help a Grieving Friend
  7. End the letter with a thoughtful word, a hope, a wish, or expression of sympathy e.g. "You are in my thoughts" or “Wishing you God’s peace.” Closing such as "Sincerely," "love," or "fondly," aren’t quite as personal.

Example Condolence Letter

Below is an example of a condolence letter using the seven components above:

    Dear_____________,

    1. Acknowledge the loss, refer to deceased by name.
    I was deeply saddened to hear about the death of _____________.

    2. Express your sympathy.
    I know how difficult this must be for you. You are in my thoughts and prayers.

    3. Note special qualities of the deceased.
    ____________was such a kind, gentle soul. She would do anything to help someone in need.

    4. Include your favorite memory.
    I remember one time_________________.

    5. Remind the bereaved of their personal strengths and qualities.
    I know how much you will miss_______________. I encourage you to draw on your strength and the strength of your family. You could use your special talent of scrapbooking to make a lasting memory book of _________________.

    6. Offer specific help.
    I can come over on Tuesday evenings to help you make your scrapbook. I have some lovely pictures of _______________ I’d love to share.

    7. End the letter with a thoughtful closing.
    May God bless you and your family during this time and always,

    Sign your name_____________________

Keep in mind that this is only an example. Write from your heart and whatever elements you include will be the right ones.

You may decide to write a shorter version of a condolence letter on note card or on a small piece of stationary tucked inside a commercial card. If I am close enough to the deceased to have photos of them, I especially like to print one of my favorite photos on a card. That can be done from your computer or from a picture program in your local photo developing shop.

When writing a condolence note, pick just a few elements from the example on the first page of this article. Using components #1, 2, 3, and 7 is a good guide.

  1. Acknowledge the loss and refer to the deceased by name.
  2. Express your sympathy.
  3. Note any special qualities of the deceased that come to mind.
  4. End the letter with a thoughtful word, a hope, a wish, or expression of sympathy e.g. "You are in my thoughts" or “Wishing you God’s peace.” Closing such as "Sincerely," "love," or "fondly," aren’t quite as personal.

Remember that this is just a guide. You can use any of the components of a condolence letter in your note or none at all. The most important thing is to write from your heart. Sources
Zunin LM, Zunin HS. 1992. The Art of Condolence: What to Write, What to Say, What to Do at a Time of Loss
How to Write a Condolence Letter 2005. End of Life Care Curriculum. Virginia Commonwealth Universities School of Medicine.

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Helen Keller 
On Friendship

"Would that I could enrich this sketch with the names of all those who have ministered to my happiness! Some of them would be found written in our literature and dear to the hearts of many, while others would be wholly unknown to most of my readers. But their influence, though it escapes fame, shall live immortal in the lives that have been sweetened and ennobled by it.

Those are red-letter days in our lives when we meet people who thrill us like a fine poem, people whose handshake is brimful of unspoken sympathy, and whose sweet, rich nature impart to our eager, impatient spirits a wonderful restfulness which, in its essence, is divine. The perplexities, irritations and worries that have absorbed us pass like unpleasant dreams, and we wake to see with new eyes and hear with new ears the beauty and harmony of God's real world.

The solemn nothings that fill our everyday life blossom suddenly into bright possibilities. In a word, while such friends are near us we feel that all is well. Perhaps we never saw them before, and they may never cross our life's path again; but the influence of their calm, mellow natures is a libation poured upon our discontent, and we feel its healing touch, as the ocean feels the mountain stream freshening its brine."

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No matter how much you love the one you are caring for, caregiving can get tough. The following are normal feelings a caregiver may go through. If you know a caregiver please give (not just offer) help, and at the very least, encouragement. pg

~~~~~~~~~~~~~~~~~~~

 Normal Negative Feelings a Caregiving May Have

In case you're feeling guilty for the conflicting thoughts in your mind, we wanted you to see a few of the comments we received when we asked how people's lives had been affected by caregiving. After you read a few of these, you'll see that what you're feeling is normal and that you're not alone. It wouldn't hurt to print these out and keep them by your bedside to remind yourself that what you're feeling is normal. "Stress and depression have set in."

The emotional problems have just about driven the family apart."

"I'm experiencing depression and just a 'there's no way out' feeling."

"It's a typical sandwich scenario — you care for elder parents and children and there just isn't much left for yourself and/or your spouse."

"I feel I have no time to myself unless I'm in the restroom, at work or in my vehicle."

"I have a great resentment towards family members who try to micromanage long distance. They have no idea how hard this is."

"I grieve the difficult changes having a stroke has caused my loved one to endure."

"I see life from an entirely different perspective. I feel like I'm living in a parallel universe of some kind, everyone around me is living a normal life, life goes on, I pass people going about their day to day life but my life is someplace totally disconnected from everyone. My relationships with my Mother, my family, people at work have all changed. Everyone counts on me to solve their 'problem of the moment' but I am only one person and there are only 24 hours in the day."

"I felt anger and loneliness … people don't have a CLUE unless they have REALLY TAKEN CARE of someone. Seven months later I still feel outside of myself wondering when I will be normal and full of fun again. But I wouldn't change a thing I did for my mom. I have no regrets."

"Sometimes I have a feeling of guilt that I am able to do things and the person whom I help take care of can't do a lot of things anymore."

"I don't get any assistance from other family members. However, they are always willing to give an opinion or pass judgment."

"We have gone through total role reversal. Now he stays home while I go out to work."

"I can't commit to anything for fear she will end up in the hospital again and I will have to drop everything as I just did recently. I have no other siblings so it is all on me."

"I feel the pressure of making decisions for the loved one and having that person mad at me."

"I feel like I'm neglecting duties as a parent. I am unable to attend church services. I can't even THINK about a romantic life."

"There is such a lack of appreciation and constant fighting between my parents."

"My husband and I had one life one day — and a whole different one after his stroke."

"At first my family gave me a lot of support but that has vanished."

"I can't go on vacation. Can't go out with just my husband. Don't have a life other than caregiving."

"My world has been turned upside down."

"I don't meet up with friends. I am always confined to the house and also very scared to leave my spouse alone."

"I find I neglect my own family to care for my father."

"He expects constant attention, although he can walk around and take care of his personal needs. He is always saying do this or hand me that, etc. No personal time for myself until I go to bed in a separate bedroom."

"My husband used to care for me; now I have to care for him. I miss the protection and feeling I used to have."

"It's constantly on my mind, no matter what I'm doing."

"I'm upset with my husband for refusing to help my mother."

"I'm failing this semester."

"Sometimes I drive back and forth as many as six times a day plus take my lunchtime to care for him. But I must protect my job."

"I was a stay-at-home mom but I had to return to full-time work as well as take on all the responsibilities my husband can no longer handle. Mother-in-law had to move in to help with child care and caregiving while I work. It's a big strain to have someone else living in our home."

"I feel as though I've lost my best friend."

www.heart.org

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Our parents (and we, ourselves) often take what the doctor prescribes without question and we end up being shocked at the price of the drug. We shouldn't be embarrassed to ask our doctor questions about the costs of prescribed mediction, as well as medical tests. Our doctors may not keep up with the costs of these, or he may assume our insurance company will take care of the added cost; if this is the case, we need to educate our doctors! 

Ways to save money on prescription drugs.

(Sorry. I forgot to copy the source of these tips. pg)

1. Tell your doctor you can't afford the drugs he's prescribing.

According to the Consumer Reports survey, only 4 percent of those polled said they'd had a conversation with their doctors about the cost of a drug. You shouldn't hesitate to talk to your doctor about prices; these days, many people can't afford the skyrocketing price of prescription drugs.

"There's such an embarrassment level," Rodman said. "They stop taking the drugs, and they never tell me why."

2. Ask your doctor whether there's a generic that would work just as well.

It's amazing how much money you can save with this one little question. For example, if your doctor prescribes Lunesta, a sleeping pill, you could end up paying about $93 for 15 doses. Switch to zolpidem, which is the generic form of Ambien, and you'll pay $33 for the same number of doses, according to Consumer Reports Best Buy Drugs.

To make it really easy, bring in a list of the $4 generics sold at your local pharmacy and hand it to your doctor. If there isn't a generic that will work for your particular problem, ask whether there might be a less-expensive brand name available. Santa suggests wording it like this: "Can you tell me about other options that would cost me less?"

3. Ask the pharmacist for less-expensive alternatives.

If you didn't get a good answer from your doctor, ask your pharmacist whether there's a less-expensive drug in the same class as the one your doctor prescribed.

4. Use mail order.

You'll save money. Of course, this won't work when you need medicines immediately (for example, antibiotics for an infection), but mail order often works well for medicines you need to take long-term.

5. Find a prescription assistance program.

There are several out there to help people who can't afford their prescription drugs. Consumer Reports has advice on choosing a prescription assistance plan.

6. Be suspicious of free samples.

Samples are indeed enticing. But what a lot of people don't know is that samples are often for the most expensive drugs on the market. Although the samples will help you out for a month or two, after that, you'll have to start forking over the big bucks by yourself. For more information, see http://www.cnn.com/2008/HEALTH/04/24/ep.samples/index.html.

7. Don't push for what you see on TV.

Just as samples are often for the pricey drugs, TV commercials are also often for pricey drugs -- and drugs that don't necessarily work any better than cheaper alternatives. If you ask for what you see on TV, there's a chance your doctor might prescribe it -- and you'll get sticker shock at the pharmacy.

8. Split drugs with caution.

Sometimes you really can save money by asking your doctor to prescribe a double dosage of a drug and then splitting the pills in half. But there are safe and unsafe ways to split drugs, and some drugs should never be split at all. See Consumer Report's guidance on splitting drugs below this article.

There's a flip side to this. Let's say you're taking 10mg of a drug, and it's not working, so your doctor ups your dose to 20 mg. Don't take two of the 10mg pills, warns Dr. Robert Epstein, chief medical officer at Medco, a prescription drug insurance company. That'll end up costing you money, because you'll go through your drugs twice as fast. "Instead, ask for a single pill that has the higher strength," Epstein advised.

9. If you don't have insurance, shop around.

Pharmacies sometimes charge very different prices for the same drugs. In fact, Consumer Reports found that prices for the same bottle of pills can vary by more than $100.

Health Library

  • MayoClinic.com: Buying prescription drugs online

10. Ask for a review.

You may be taking medicines you don't need, especially if you see a variety of doctors who don't talk to one another about what they're prescribing. "Bring your drugs in to one doctor and say, 'Do I need to be taking all these?' " Epstein said.

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Should You Split Your Pills?

Consult your doctor about pill splitting. The dose you take of most medicines is very important. If you don’t get the right dose, the effect of the drug may be substantially reduced. Your doctor should know which drugs can be split and which cannot. You can consult a pharmacist, too, who may be willing to show you how to split your pills. Pills are only safely split in half and never into smaller portions, such as into thirds or quarters. There is no official, complete list of medicines that can be split, and some drugs are dangerous to split. That makes it doubly important to consult a doctor or pharmacist. Generally the following kinds of pills should not be split:

  • Chemotherapy drugs
  • Anti-seizure medicines
  • Birth control pills
  • Blood thinners (Coumadin, warfarin)
  • Capsules of any kind that contain powders or gels
  • Pills with a hard outside coating
  • Pills designed to release the medication over time in your body
  • Pills that are coated to protect your stomach
  • Pills that provide drug release throughout the day
  • Pills that crumble easily, irritate your mouth, taste bitter, or contain strong dyes that could stain your teeth and your mouth.
  • Examples of medicines that cannot be split include oxycodone (OxyContin) for pain, omeprazole (Prilosec) for heartburn, and cetirizine (Zyrtec) for allergies.
  • Some pills may deteriorate when exposed to air and moisture for long periods after being split. Therefore, you should not split your pills in advance. Instead, do it on the day you are taking the first half. Then take the remaining half on the second day.
  • Don’t split your pills with a knife. This can be dangerous and generally is imprecise. That is, it leads to unequal halves too often, studies show. Instead, purchase a pill splitter. They cost from $3 to $10 and are available at most pharmacies and large discount stores. A device for splitting oddly shaped pills may cost more, up to $25. Some insurers will send you a pill splitter for free so check with your health plan.
  • If you have poor eyesight, or if you have an ailment like arthritis or Parkinson’s disease, it might be difficult for you to split your pills. You should talk with your doctor about whether it might be too much of a burden.
  • Likewise, people with memory problems or impaired thinking are not good candidates to split their pills.
  • The easiest pills to split are relatively flat round ones with a scored center. That’s a slightly indented line that runs across the center of the pill. However, not every pill that has a scored center is meant to be split. Again, consult your doctor or pharmacies

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"God does not comfort us to make us comfortable, but to make us comforters."

Now we that are strong ought to bear the infirmities of the weak, and not to please ourselves. Let each one of us please his neighbor for that which is good, unto edifying. For Christ also pleased not himself; but, as it is written, The reproaches of them that reproached thee fell upon me. For whatsoever things were written aforetime were written for our learning, that through patience and through comfort of the scriptures we might have hope. Now the God of patience and of comfort grant you to be of the same mind one with another according to Christ Jesus: that with one accord ye may with one mouth glorify the God and Father of our Lord Jesus Christ. Wherefore receive ye one another, even as Christ also received you, to the glory of God. (Rom 15:1-7)

  • Ignoring the infirmities of the weak is pleasing ourselves.
  • Telling the weak what we think about them, without listening, is pleasing ourselves.
  • Judging the weak on appearance or heresay is pleasing ourselves.
  • Doing anything to the weak that is not edifying for them is pleasing ourselves.
  • Making sure we are not uncomfortable in anyway when edifying is pleasing ourselves.
  • Glorifying ourselves instead of God is pleasing ourselves.
  • Not having the mind of Christ towards those who are weak is pleasing ourselves.
  • Not receiving the weak, as Christ received us, is pleasing ourselves.
  • Ignoring the strong who may be temporarily weak is pleasing ourselves.

"Love is being happy for the other person
when they are happy
being sad for the other person when they are sad
being together in good times
and being together in bad times
Love is the source of strength."

I may not always be by your side,
but my prayers will be with you.
I may not always help you,
but deep inside you know I want to.
I may not always do what you like,
but I will do the best I can.
I may not always understand,
but we can still walk hand in hand.
I may not be the perfect friend,
I may not be the best out there,
but in spite and despite all these,
you can be sure somebody cares!

-unknown

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What A Friend We Have In Jesus

What a friend we have in Jesus,
all our sins and griefs to bear!
What a privilege to carry
everything to God in prayer!
O what peace we often forfeit,
O what needless pain we bear,
all because we do not carry
everything to God in prayer.

Have we trials and temptations?
Is there trouble anywhere?
We should never be discouraged;
take it to the Lord in prayer.
Can we find a friend so faithful
who will all our sorrows share?
Jesus knows our every weakness;
take it to the Lord in prayer.

Are we weak and heavy laden,
cumbered with a load of care?
Precious Savior, still our refuge;
take it to the Lord in prayer.
Do thy friends despise, forsake thee?
Take it to the Lord in prayer!
In his arms he'll take and shield thee;
thou wilt find a solace there.

 Friendship

Some general teaching about friendship. In the first place, the Bible says, "A man that hath friends must show himself friendly" (Prov. 18: 24). Some are too distant to form friendships. There is great value in friendship. "Two are better than one," wrote the wise man (Eccl. 4: 9). A true friend will stand by, even in times of trouble. "A friend loveth at all times, and a brother is born for adversity," the Bible says (Prov. 17: 17). To the converse, the Bible speaks of false friends when it warns, "Confidence in an unfaithful man in time of trouble is like a broken tooth, and a foot out of joint" (Prov. 25: 19). There are some people that are not desired to be friends. For instance, "Make no friendship with an angry man; and with a furious man thou shalt not go" (Prov. 22: 24). A true friend will tell us when we are wrong. Hear the Bible, "Faithful are the wounds of a friend; but the kisses of an enemy are deceitful" (Prov. 27: 6). Genuine friends must be cherished and not forsaken (Prov. 27: 10).

Jesus and friendship. Jesus is the only begotten of the Father, full of grace and truth (Jn. 3: 16; 1: 14). Yet, Jesus offers man his friendship. Jesus said, "Ye are my friends, if ye do whatsoever I command you" (Jn. 15: 14). Jesus is the ultimate friend of man. "Greater love hath no man than this, that a man lay down his life for his friends" (Jn. 15: 13). Jesus tasted death for every man and shed his blood for the remission of man's sins (Heb. 2: 9; Matt. 26: 28).

    In closing, true friendship is one of the great gifts of life. As we saw, man in his friendship with Jesus, must obey Jesus (Jn. 15: 14). We must believe, repent, confess Christ's deity, and be baptized (Jn. 8: 24; Lk. 13: 3, 5; Rom. 10: 9, 10, Matt. 10: 32; Mk. 16: 16). Jesus' friendship is unequalled!

http://www.biblequestions.org