What Matters Most . . . and All That Jazz!

Helping people is what we do.  Improving their quality of life is our mission.  Sometimes it doesn’t take much to make people really, really happy.  Most people who work in the home care business get job satisfaction from helping seniors and others with everyday tasks that most of us take for granted but which mean the world to the recipient of the assistance.

I met a woman a week or so ago who has been a musician her entire life.  When she immigrated to the United States almost sixty years ago at age 18, “Mavis” was already an accomplished musician.   Her mother was a professional classical violinist, so Mavis had a good teacher.  Mavis met her husband in a jazz club in Minneapolis and the two of them hit it off immediately!  They formed a marriage partnership as well as a professional musical team and toured the United States playing jazz and blues in places such as Nashville, New Orleans, and Memphis.

Mavis is still in love!   Her eyes and face light up when she talks about her passion.  Her professional and life partner husband passed on some years ago, but Mavis still has her music!  It’s the one thing in life that keeps her going and makes her life worthwhile.  She reads about music, studies it, and still plays it on the small electronic piano she keeps in her tiny one-bedroom apartment, getting a little bit miffed that she can’t play it full force or else she gets complaints from her neighbors!  “They just don’t understand”, she says, “how beautiful music is and how important it is to me!”  She enjoys going out to jazz clubs but can no longer drive at night and no longer feels it’s safe for her to be out after dark alone as a 77-year old single woman and with a broken arm from a fall.

Since Mavis is independent in the upkeep of her apartment, her cooking,  laundry, and personal cares, her only request was for us to find a caregiver who enjoys jazz as much as she does and who would be willing to  take her to jazz clubs once a week in the later evening hours.  I can’t tell you how elated she was when I called her this morning to tell her that I had found a woman who was willing to go out with her every Friday night to listen to jazz.  “I can’t believe it, I can’t believe it!” she said.  “Thank you so much!”

Companionship and transportation to events and activities that people enjoy not only makes them happy but gives them something to look forward to each week.   It gives them a break from the monotony and boredom that can set in when they can no longer drive and they have no one to take them places.  Even if someone lives in a senior building with activities, sometimes they are not the preferred activities for every individual living there.  Sometimes, it’s just good to get out of the building for fresh air and a change of scenery.

A ride to a jazz club once a week may not seem like much to most of us, but it is what Mavis lives for.

Paul R. Blom, Owner/CEO
Right at Home
P: 952-854-6122



5 Commons Errors in Taking Care of Elderly Parents

There are no fool-proof maps than can show the best way to care for an elderly parent.  But there are some common “potholes” that can make the road difficult to travel.  To help you on your caregiving journey, here are five more common errors adult children make in taking care of their elderly parents.

1. Not Taking Fall Hazards Seriously

There are many simple modifications you can make at home to reduce the risks of falls:  eliminate throw rugs, keep walkways clear, improve lighting, install grab bars next to your toilet and in tub or shower, keep commonly used items at an easily reachable height, and make sure stairways have handrails.  Encourage your loved one to turn on a light when using the bathroom at night, and make sure hallways and stairways are well lit.  It is also a good idea to have a licensed occupational therapist do a home safety evaluation.  Of course, one of the best ways to protect from falls is to maintain your strength through routine exercise and balance training.  Physical therapists provide tremendous support in helping seniors stay fit, balanced, and safe in their homes.

2. Not Planning Ahead

If you have a parent who is beginning to experience a significant decline in health and functioning, it is important to make a plan.  Anticipate increasing need for help in the home, and discuss different ways for meeting those needs.  It is a good idea to call a family meeting and discuss all available resources, recognizing that more and more help may be needed as time goes on.   Make a plan BEFORE a crisis hits.  It can be awkward to discuss at first, but no one thinks clearly in an emergency.

3. Trying to Do it All Yourself

Consider carefully what you are able to give as a primary caregiver and know your own limitations.  Many people want to do it all and set out with all guns blazing, ready to meet Mom and Dad’s every need.  Be realistic!  Acknowledge that every person is different in what they are able to give.  Seek out available support systems BEFORE you feel like you desperately need them.  Be creative in getting others involved.  The old adage “It takes a village to raise a child” can be just as true for an adult family member with considerable health issues.  If family members or friends are not available, look into volunteer organizations or home care companies that can help.  You may feel like you are indispensible, but if you take a step back in your level of involvement, you may be surprised to find your loved one utilizing other resources to help.  Don’t feel guilty about taking care of yourself.  It’s essential!

4. Not Taking Burnout Seriously

If you balked at everything stated in #3 above, please read #4 carefully!  It is common for family caregivers to experience significant declines in health as a result of the strain of caregiving.  DON’T ignore the signs of burnout.  The Alzheimer’s Association lists ten warning signs of caregiver stress: Denial, anger, social withdrawal, anxiety, depression, exhaustion, sleeplessness, irritability, lack of concentration, and health problems.  If you are experiencing a high degree of caregiver stress, take necessary steps to care for your own needs.  Ask for help.  Set your boundaries, communicate them clearly, and stick to them.  Take a break.  Don’t neglect your personal relationships.  Join a support group.  Engage in activities that revive your mind, emotions and spirit.  Take the time to eat something other than fast food!

5. Ignoring Parents’ Boundaries

Sometimes in managing the immediate concern for a parent’s physical needs, we ignore the need to respect their own personal boundaries.  For example, in attempting to keep your mom safe, it is easy to steamroll her need to be independent.  In wanting to make sure that your dad is not living in a messy home, you may compromise his right to determine his own standard of cleanliness.  Be aware of how your own desire for peace of mind and security may compromise your parent’s deeper need for emotional support, self-determination, and the freedom to take risks.

Paul R. Blom, Owner/CEO
Right at Home
P: 952-854-6122



Getting Your Money’s Worth at the Doctor

As we get older, it seems, at least for many of us, that our trips to the doctor become more and more frequent.  To make things worse, our trips are no longer one-stop shops.  There’s a different doctor to see for every medical ailment affecting our bodies.  This means, of course, that we go to the cardiologist on one day, the neurologist on another, the eye specialist on a different day—you get the picture—and in no time we find we are spending  most of our time lining up transportation and then sitting in waiting and exam rooms.  The doctor pops in, and before we even know what’s happened, he or she is running out, saying, “I’ll see you again in three months.”  And after he or she is gone, you realize you didn’t even get a chance to ask all of your questions!

Many adult children in the sandwich generation accompany their elderly parents on hospital visits.  Whether going for yourself or with your elderly parents, here are some ways to ensure that you make the most of both your and the physician’s time and energy:

  1. You will be more prepared if you write down your questions as you think of them before seeing the doctor. Keep a running list of them on your refrigerator or somewhere else that is handy for you.  When you go to the doctor, take the list with you.  All of your questions will be right there so you won’t have to rely on your memory, which is especially important if the doctor is in a hurry and wants to rush out the door.
  2. It’s a good idea to take someone with you. There are several reasons for this.  Maybe your hearing isn’t so good or your memory isn’t what it used to be.  Having another person with you lessens the chance that you may not hear or understand everything the physician is telling you.  Also, if you receive bad news of any kind, you’ll have someone with you to support you.  And, most importantly, you can go out for lunch together afterwards!
  3. Be honest and thorough with your doctor in reporting your symptoms, concerns, or problems. If you are not willing to tell your physician everything, he or she may not be able to treat you successfully.  Leaving out information alters the conclusions that a professional can make about your situation.  Some things, like incontinence issues, sexual issues, or loneliness, may be embarrassing to discuss.  Rest assured professionals have heard all of these things before and will better be able to address your issues if they know the whole story.
  4. A pen, a notebook, and sometimes even a tape recorder can be helpful and appropriate to bring with you when you know that a lot of new information is going to be communicated.
  5. Ask the doctor to slow down or repeat information if he or she is talking too fast. It may be necessary to ask the professional to use words that you understand if they are using medical terminology that is unfamiliar to you.  Once, when I got a new diagnosis, I had to do that.  The doctor was rattling on and on, and I was so upset that I was not hearing or understanding very well.  I finally said, “Look, this information may be routine to you.  I’m sure you say it 50 times a day to other patients, but this is the first time I’ve heard it.  I need you to slow down.”  It made a huge difference for the better in the relationship I have with this doctor now.  Sometimes doctors are just in a hurry and don’t realize how that affects the way they relate to you.
  6. When leaving, ask for written information if you feel you did not understand or are afraid you will forget what you were told. Some doctors will do this for you themselves.   If they are not able, ask a nurse to summarize and record the information for you.
  7. Do your own research about your particular conditions or disease processes prior to your appointment. You can learn a lot by discussing medical concerns with trusted friends or acquaintances, going to the library, or by going online.  You will be better prepared and your questions will be more specific.
  8. Know your body! Many times we defer to our physicians because we think they know more than we do.  It’s a good idea to remember that you are the expert on your body.  Recognize changes to your body and report to your physician new signs and symptoms, improvements, stress or emotional changes, drug side effects, etc.   Sometimes subtle body changes can be crucial in determining what is going on in the big picture and may make a difference in how your condition is treated.
  9. Lastly, if you are not satisfied with the way you are treated and if, after asking for what you need, your doctor is not able to provide that for you in a way that makes you feel respected and comfortable, you always have the choice to see a different doctor.

Paul R. Blom, Owner/CEO
Right at Home

P: 952-854-6122



Eldercare at Home: When Mom Refuses Help

“Lilly” wasn’t a Right at Home client, but she actually was a Right at Home client.  And she was to get a Right at Home caregiver who wasn’t really a Right at Home caregiver.

And if you think that sounds confusing, try explaining it to her potential caregivers.

Lilly was an intelligent woman in her seventies who was working very hard to mask her dementia.  In fact, she refused to acknowledge her Alzheimer’s diagnosis, and any discussion of the topic was strictly off limits.

The problem was that, although she denied her memory loss, Lilly needed help.  Like many people in her shoes, Lilly was losing her ability to take care of herself or to live safely on her own.  In addition to needing someone to tidy up her apartment, she needed an at-home caregiver to prepare meals so she wouldn’t forget to eat.  She also needed reminders to take her medications.  Her family wanted to have time to select the perfect memory care facility, but until then, they wanted to use an assisted home care company to ensure that Lilly was safe and healthy.

Lilly’s rejection of her diagnosis, however, wasn’t the only problem.  Not only did Lilly live in denial, but she had also always been very frugal with money.  Since that didn’t change with her diagnosis, her family knew Lilly would refuse any help if it cost money.

The solution was that Lilly would not be receiving paid in-home help from Right at Home.  Our social worker arrived at her home under the guise of a volunteer coordinator from a nearby church.  Instead of having a structured intake, Lilly believed that our social worker was there to coordinate volunteer services.  Any caregivers who arrived were then identified by her family as volunteers.

Senior care is a funny business.  When you enter someone’s home, you need to be respectful of the life they live and be sure to provide care with dignity.  For Lilly, that meant never acknowledging her memory loss or her need for senior home care services.

Lilly’s situation is not unique.  It’s not uncommon for families who are taking care of elderly parents to get creative to ensure that their parents are having their needs met.  Sometimes, all it takes is a little bit of thinking outside the box to keep Mom safe.

Paul R. Blom, Owner/CEO
Right at Home

P: 952-854-6122



Depression Is Not a Normal Part of Aging

“Lorraine’s” at-home caregiver always arrived on time and ready to perform her homemaking tasks, but Lorraine could never decide what she wanted her caregiver to do. Lorraine couldn’t make any decisions about what she needed help doing, so she’d go into the kitchen and make breakfast, leaving her caregiver alone in the living room to figure out what to do with her time. When Lorraine would finally give direction, she would then inevitably change her mind. Her caregivers, of which there were several, felt like they could never please Lorraine.

In addition to her indecisiveness, Lorraine had a flat affect and reported vague physical complaints which were not of concern to her medical doctor. Her physician had been telling her for many, many months that she was suffering from depression. Unfortunately, Lorraine refused to seek help for her depression. Because or her religious beliefs, she was waiting for “God to make it better,” even though her care management nurse, her physician, and her home care nurse each had recommended a trial of antidepressant medication. I also did my best to convince Lorraine to try an antidepressant but to no avail. After three years, Lorraine was still waiting for God to heal her depression. It was affecting her relationships and, unfortunately, she eventually lost her elderly home care service as well. It was just too frustrating for caregivers to work with Lorraine. They felt helpless.

What exactly is depression? According to the Mayo Clinic, it is a “medical illness that causes a persistent feeling of sadness and loss of interest. Depression can cause physical symptoms, too.” People with depression tend to isolate themselves. They lose interest in life and usually have sleeping and/or eating problems, two of the most common symptoms of depression. Not having an appetite, weight loss, weight gain, and eating too much can all be symptoms. Not being able to get to sleep, awaking in the middle of the night, or not being able to sleep at all can also be symptoms, as well as wanting to sleep all of the time. It is estimated that 5-6 million people over the age of 65 have depression. One study indicated that as many as 25% of the elderly are depressed.

When we think of depression, we associate it with a dictionary definition characterizing it as “extreme gloom, feelings of inadequacy, and an inability to concentrate.” While depression may manifest itself in typical ways—having “the blues,” crying, or exhibiting a feeling of hopelessness—according to Kay King of NAMI Minnesota, depression sometimes comes out sideways. Other common symptoms of depression include (but are not limited to):

Poor Concentration
Sleep Disturbances
Self Doubt
Mood Swings
Vague Physical Complaints
Feelings of Guilt
Feelings of Helplessness
Lack of Energy
Weight Loss or Gain
Under eating
Suicidal Thoughts
Feeling Overwhelmed
Decreased Cognitive Function
Obsessive thoughts

If you are taking care of elderly parents and find they have been experiencing several of these symptoms for 2-3 weeks or more, you should definitely have them evaluated for clinical depression.  While most everyone experiences “down” periods at certain times in their lives, real depression is more than an occasional period of feeling blue.  It is an ongoing medical condition that people cannot choose to control, stop, or “snap out of.”

In addition to common physiological and environmental causes, depression in seniors can also be caused by side effects of prescription drugs, thyroid issues, and even some medical procedures.  It is not uncommon for a cerebral vascular accident, for example, to bring on depression after the stroke.  Additionally, chronic illnesses, such as diabetes, cancer, or heart disease, can also bring about depression.  While coping with a chronic illness is always difficult, it is not normal to become clinically depressed.  Treatment for depression, in some cases, may actually improve symptoms of other conditions.  Other contributors to depression in the elderly are grief, loss, loneliness, chronic pain, memory loss, alcoholism, boredom, and feeling that life no longer has purpose or meaning.

If you suspect the senior in your life is experiencing depression, it’s important to take your concern seriously and to intervene as quickly as possible.  Not only will depression affect quality of life, but white men over the age of 85 are at the greatest risk for suicide of all age-gender-race groups, 2.5 times higher than the rate for men of all ages.  Depression is not a normal part of aging, and fortunately, it is a treatable medical condition.

Unfortunately, those who are now seniors grew up in a time when there was much more stigma around mental illness.  They are terrified by any suggestions of mental illness, fearing they’ll be “locked up.”  They come from an era when people were ashamed to admit they had family members with mental illness for fear of being called “crazy.”  If someone had depression, it was kept hush-hush. We now know that depression is a treatable medical condition just like high blood pressure, diabetes, or asthma.

If you suspect the seniors in your life are suffering from depression, please take your concern seriously.  Encourage them to talk to their doctor or a licensed mental health professional.  The best treatment for depression is a combination of anti-depressant medications along with professional counseling (psychotherapy).  Nonmedical interventions, such as having regular family visits, regular exercise, senior companion care services, hobbies, as well as increasing social activity and having something meaningful to do, can also be helpful.  Most people who have depression, with the right treatment, can live much more meaningful and quality lives.  There is no need to suffer.

Paul R. Blom, Owner/CEO
Right at Home

P: 952-854-6122



Maintenance Therapy – The Best Kept Secret in Senior Care!

By Above & Beyond Senior Services

Have you ever needed physical or occupational therapy (PT/OT)? Conditions that cause decreased strength, range of motion, balance deficits, difficulty with walking and memory issues are leading reasons seniors might need therapy. Most therapy is based on a model that requires patients to meet certain qualifying criteria. Typically, a person must demonstrate measurable, skilled progress or the therapy provider is required to discharge. Over the course of the last decade, a new option for wellness and exercise has become increasingly available to Minnesota seniors!

Maintenance therapy is the same PT/OT that you are familiar with, but with a few differences:

  • Starts after traditional therapy ends.
  • Has no requirements for frequency or duration of service.
  • Can continue on a long-term basis.Comes into the home, while allowing freedom to be active throughout the community.

Let’s meet Mary:

Mary had a massive stroke at 68. She was left with an inability to walk, difficulty with speaking, and decreased movement on the left side of her body. After completing rehabilitation in the hospital, then a care facility, she was able to return home with her husband, Ed. She also qualified for Medicare home therapy. When Mary was no longer considered homebound, she transitioned to an outpatient clinic. Mary was very motivated to get better, but this proved more difficult than imagined. It was hard to be disciplined in completing the home exercises her therapists assigned. Ed began to notice declines, despite Mary going for therapy twice a week. They were disappointed in her regression. It was time for a change. She wanted home therapy that focused on the tasks and activities that were important to her and allowed them to be in control of her rehab. Thanks to a recommendation from a trusted health care worker, Ed inquired about direct-pay, maintenance therapy.

The maintenance therapists helped discover Mary’s abilities and limitations. The couple’s therapy goals were set collaboratively. These weren’t goals for the purpose of insurance coverage, but the goals that were important to both of them. They were finding their “new normal”. Her desire to maximize her mobility, strength and balance was met by creative exercise instruction from her therapists. Over time, with PT/OT each week, Mary had many successes. Eventually she was able to walk throughout her home, enjoy her swimming pool and an adaptive horse-riding program! Her quality of life was significantly improved as she met her goals of participating in community activities and going out to dinner with Ed. She felt empowered, engaged and happy about her accomplishments.

While many people desire and achieve goals of improvement, maintenance therapy also understands that sometimes, true “maintenance of ability” IS the goal. Many seniors get caught in a cycle of decline which leads to hospitalization and rehab. Once home again, it’s difficult to maintain exercise programs independently. Lack of adequate maintenance leads to progressive decline and the cycle begins again. Introducing maintenance therapy can be a life changer for a senior.

When a client has ongoing, one-on-one therapy, they are able to maintain their physical abilities. This makes the difference between staying at home vs. moving to assisted living or nursing home. A benefit of maintenance therapy is the same therapist can continue with clients if they change the place they call home.

If you are a senior who wants to either regain or maintain your quality of life through wellness and exercise, maintenance therapy may be the missing link that you have been searching for.

Allison Bakke, OTR/L
Above & Beyond Senior Services