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Take Care: A family caregiver resource

April/May 2009

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Whether it's tips for fall prevention or suggestions for letting others help out, we have information you can use. Pass it on!

Balance exercises, an important step in preventing falls

If remaining independent is a goal for your older relative, bringing some balance to his or her life is essential—balance exercise, that is.

Falls account for 90% of all hip fractures. They also account for more emergency room visits than do any other type of injury. Especially for seniors, falls pose a danger to an independent lifestyle. They often usher in a permanent need for daily assistance.

You can easily support your loved one by doing balance exercises together.

  • No muss, no fuss. No special clothing, no special gear, and not even much floor space is needed for balance activities. A table or chair to hold on to is advised for beginners.
  • Routines are simple. Mom won't be daunted by the balance activities recommended by the National Institutes of Health. The knee lift, leg lifts, and tiptoe exercises are easy to do. Tai chi is another example of a good balance activity.
  • Only 30 minutes a week. A 2008 study found that 15 minutes of balance exercises twice a week for a period of 6 months or more significantly reduced the chance of a fall. Investing only 30 minutes a week may keep both of you from countless hours in the emergency room!

Of course, aging isn't the only reason people fall. If your loved one seems to have a balance problem, a full physical exam is advised.

The National Institute on Aging offers simple instructions, videos, and photos on all types of exercises for seniors.

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Have you completed an advance directive?

Ben Franklin is famously quoted as saying "nothing can be...certain except death and taxes."

April 16 is National Healthcare Decisions Day. With your taxes out of the way, this is a perfect opportunity to handle the paperwork relating to that "other inevitability."

An advance directive is a document that outlines an individual's wishes for health care. It provides decision-making guidance should illness or accident render someone unable to speak for him- or herself. You may have a sense of your family member's wishes. But it's even better if those wishes are written down in the form of an advance directive.

Like tax preparation, procrastination is the number one reason people give for not completing an advance directive. Use National Healthcare Decisions Day as an excuse to start the process:

  • Make it a family project. You need an advance directive, too. Dad just might be willing to complete his if you're working on yours at the same time. After all, any one of us could be in a car accident tomorrow.
  • Do it at home. You can download advance directive forms from any of the 50 states at no cost. A lawyer is not required.
  • Discuss your own wishes. Explain that you want others to know your preferences. If you speak first, you may relieve Mom's discomfort with the topic.
  • Listen without judgment. Your loved one's wishes may be different than yours.

Once a directive is completed, distribute copies to the physicians and family members who may need it in an emergency. Make April 16 a day for annual review. As circumstances change, views and wishes may change as well.

If you are concerned about how to broach the subject, check out our article, "Starting the conversation."

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Letting others pitch in

Caring for an older relative has many rewards. But that doesn't mean you don't need a break now and then to recharge your batteries. Many family caregivers don't take needed breaks because they worry that others won't do a good enough job in their stead.

Although concern for your loved one's comfort and safety is appropriate, it's also important to distinguish between real threats and a tendency toward perfectionism. For instance, it's not uncommon for one sibling to feel like none of the others help. At the same time, the other siblings feel there "isn't enough room" for them to pitch in because the primary caregiver is so particular about if, when, and how things get done.

Voltaire once said, "The perfect is the enemy of the good." If you are having trouble getting, or allowing, others to help, you might want to consider the following:

  • Is a hot dinner every night necessary, or could Dad be just as satisfied by a hearty sandwich?
  • Your sister might not do your mom's hair just right, but the tradeoff may be opportunity for a rekindling of their relationship.
  • As a compassionate friend, what advice would you give someone in a similar situation?

Researchers in the area of perfectionism also suggest slowly "desensitizing" yourself to less-than-perfect situations:

  • Start small. Ask someone to take over a routine task such as picking up a prescription.
  • Consider it an "experiment," not a permanent change.
  • See what happens. If things don't go as planned, were the errors life threatening for your loved one or simply irritating for you? Would practice or more information have enabled the helper to do better?
  • Were there any positives to the situation? Did they have value?
  • Try again. Don't expect it to be easy the first time. As with any learning process, the more you do it, the more comfortable it will feel.

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Please Note: Crossroads Hospice does not specifically endorse the activities of any organizations mentioned here, but offers their information as a sample of the kinds of materials and services that are available.


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"My friend, Liz, fell and broke her hip. She had to move in with her children. It was hard on everyone... I want to do everything I can to make sure I don't fall. I like living on my own too much!"
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