Because We Care
Practical tips for family caregivers

If you have to go to the Emergency Room

About one of every five seniors goes to the ER in a given year. Most ER visits are literally “by accident.” But some conditions, like congestive heart failure, often result in frequent trips to the ER. Taking a few simple steps to prepare ahead of time can reduce some of the stress.

Create an “ER kit” and keep it updated with

• Medical information: A list of your loved one’s conditions, medications, allergies, and past surgeries. Include contact information for current physicians. Consider subscribing to a service such as MedicAlert, which stores essential information online for 24/7 access.
• Insurance information: A copy of your family member’s insurance card(s). Include any supplemental policies.
• Advance directive: This helps ensure your loved one’s preferences for life-sustaining treatment are followed. (See our article about health care planning.)
• A change of clothes in case your loved one’s garments become wet or soiled.
• Stress-relieving supplies: ER visits are often lengthy and tiring. Pack water and snacks and cash for purchases. A pen and paper, a light sweater, and reading material or CDs can also come in handy.

What to Do: Strive for balance.

• Support your loved one with your calm attention.
• Provide information to ER staff as requested. Your input is essential to help them understand what’s different from “normal.”
• Ask for periodic updates. It’s fine to ask every 40 to 60 minutes for an update. If your family member’s condition seems to worsen while you are waiting, alert ER staff immediately.
• Observe and take notes. Write down what procedures were done and what medications were given.
• Get instructions. Don’t leave without written instructions. Ask specifically about the diagnosis, follow-up care, and any new prescriptions. Be sure you understand when to call the doctor. If you are uncertain, ask questions until you know what to do.

Is it Alzheimer's disease?

When your father struggles to remember a grandchild’s name, should you be concerned? Older adults typically have some memory loss. People with Alzheimer’s disease, however, experience very specific changes in their thinking that go beyond the normal forgetfulness of aging.

You might consider dementia if your loved one has begun having difficulty with:

• Remembering new things. Do you have to give the same information over and over again?
• Dealing with numbers and logical thinking. Is Dad fumbling with the checkbook?
• Familiar activities. Is Mom leaving ingredients out of favorite recipes?
• Recognizing the passage of time. Do you have to remind your loved one of the season or year?
• Not recognizing familiar places or faces. Has Dad gotten lost while driving in the neighborhood? Is Mom not recognizing friends at church?
• Carrying on a conversation. Is Mom repeating herself or seeming to make up words?
• Losing things. Are you finding things put in odd places?
• Poor decision making. Is Dad spending money on unusual purchases? Do you have to convince Mom to bathe?
• Socializing or doing hobbies. Has Mom given up a favorite hobby or withdrawn from a group of friends?
• Staying calm. Is your loved one suddenly moody? Perhaps anxious or irritable?

Any one of these changes in behavior could signal the beginning of a more serious memory problem, or not. That is why it’s important to have your loved one checked out by a physician.

• It may not be Alzheimer’s. A number of reversible conditions look like Alzheimer’s. With proper diagnosis and treatment, these symptoms disappear.
• If it is Alzheimer’s, there are benefits to detecting it as early as possible. Medications are available that slow the progression of Alzheimer’s disease. Other medications may help relieve mood symptoms.

For more information on what’s normal and not, check out the Alzheimer’s Association’s in-depth description of the 10 signs of Alzheimer’s.

The value of support groups

Caring for an older family member presents a range of emotions and experiences. You may find yourself sometimes puzzled, sometimes sad, or sometimes just plain mad—and then guilty! The people most likely to understand your feelings and most able to provide useful tips are those in the same situation. You’ll find them in support groups.

Support group benefits. Does a support group sound like just “one more thing” in your busy schedule? Consider these benefits:

• Relieve stress. Share the humor and the tears that are normal parts of caregiving. Learn how others cope with their frustration. Get support for taking a needed next step, such as getting extra help.
• Find community. Hear others voice feelings and thoughts similar to yours. You are not alone. These folks “get it”! You’ll feel suddenly lighter.
• Get answers. Learn about a new resource. Ask how others have handled a challenging behavior.

Support group formats. Choose the option that suits your style or scheduling needs.

• Structured, educational groups typically meet weekly for up to 8 weeks. Most are led by a professional who directs discussion of specific issues.
• Open-ended or “drop-in” groups allow you to show up when it’s convenient for you—over many months or many years! These groups are facilitated by professionals or trained laypersons.
• Online groups provide the ultimate in flexibility. You can “attend” any time of night or day. And there’s no need to talk. You can sit back and “listen” until you are ready to share.

To find a group in your community, ask a trusted health professional or a religious or spiritual leader. Contact a local agency working with seniors or an advocacy group for a disease of interest. You can check our list for online groups.