Friday, January 27, 2012

"Stop warehousing old people in nursing homes!" insists author of new book

(Fort Lauderdale, FL)—“It's a national disgrace that so many families dump their elderly parents in nursing homes and assisted living facilities. Sons and daughters should invite their aging and aged mothers and dads to live them with them," says trends analyst and forecaster, and family caregiver, Stephen L. Goldstein, Ph.D. (trendsman@aol.com, http://www.rationalcaregiving.blogspot.com/).

Goldstein’s just published memoir/how-to When My Mother No Longer Knew My Name: A son’s “course” in “rational” caregiving, screams "Yes you can!" It's the first book families need to prepare for caring for again relatives, the caregiver’s "one-minute manager." Each brief, compelling, highly readable chapter turns what a son learned on-the-job into immediate help for others.

Step-by-step, Goldstein traces how his caregiving role evolved from nominal to 24/7. “I would never let my mother live in a nursing home," he says adamantly. So I had diplomatically to convince her to move in with me. Eventually, I had to learn to deal with various aspects of her dementia—getting used to finding a sandwich in the clothes dryer, changing her diaper (on rare occasions, thank God!), keeping her from choking to death--then, caring for myself after she died.

“I wrote the book I would have wanted to read before and while I was my mother’s caregiver—but which I never found!” Goldstein says. “There’s no theory here! It’s all useful information. Strategically placed throughout the book are 75 practical tips to turn my experience into advice others can use. My narratives make caregiving real. My tips make it manageable—even joyful.”

The book includes a “Caregiving Readiness Self-Assessment” so current and potential caregivers can benchmark and increase their ability to manage the often lonely, challenging, unpredictable, and overwhelming roles they may assume.

When My Mother No Longer Knew My Name is a one-man support group, written like a friend who’s “been-there-done-that,” talking anecdotally, but authoritatively, to a friend who needs help. It is raw and gritty, as well as funny and inspiring. It makes people weep, but also gives them hope that they can overcome a mountain of seemingly insurmountable challenges, for which they likely feel devastatingly unprepared.

The book and Kindle edition of When My Mother No Longer Knew My Name are available at http://www.amazon.com/, as well as at http://www.barnesandnoble.com/, http://www.hellgatepress.com/, other online booksellers and at bookstores nationwide. It is published by Grid Press, an imprint of L&R Publishing, Ashland, Oregon, http://www.hellgatepress.com/.#

Tuesday, January 10, 2012

Family Caregivers: Create your family caregiving plan--now!

by Stephen L. Goldstein, Ph.D., trendsman@aol.com (Email him your questions and comments--and he'll personally answer you!)
author of When My Mother No Longer Knew My Name: A son's "course" in "rational" caregiving

It’s a miracle we don’t have a Terri Schiavo case every day—family members battling over whether to keep clinically dead loved ones artificially alive because they didn’t put their wishes in writing. (Perhaps we do, but they just don’t make headlines.)

Plan ahead
Pitifully few adults in the overall U.S. population—between 5 percent and 15 percent--have completed advance directives detailing their health care preferences if they can’t make decisions for themselves. Few seniors even discuss end-of-life issues with their children. And yet, an estimated more than one in four elderly Americans will need someone to carry out their wishes.
Because families may need to deal with everything from caregiving options to healthcare and end-of-life scenarios, they should develop a written plan to avoid crises limiting their ability to make decisions when they need maximum certainty and flexibility. Failing to plan ahead makes you a victim of circumstances and may leave you with agonizing guilt about whether you did everything you could or should have to provide proper care.

Make out living wills
It goes without saying every adult in your family should sign a will, living will, healthcare surrogate, durable power of attorney, and any other appropriate documents. In addition, everyone who may be involved in making decisions should have up-to-date copies or know where the originals are kept. If you can’t supply papers during a medical emergency, strangers may have no other choice than to make decisions for you, perhaps against your or your family member’s desires.

Make your choices--or others will make them for you
Your family plan should be a carefully thought-out strategy and be kept current, well ahead of your ever needing it. It should also include a list of things to do to handle any emergency, with phone numbers of everyone who needs to be contacted. Early decisions during an emergency may have a direct bearing on someone’s eventual caregiving needs or end-of-life choices.
For example, if someone is put on life support who would never have wanted it, only because written instructions were not given to medical personnel, a family may have to endure the emotional agony and legal hassles of having to request he be taken off it. Or if someone else was resuscitated but not put on life support, her family may face years of caregiving costs to keep someone alive who is unconscious or seriously handicapped and who expressly said she never wanted to be in such a state.

Weigh in-home v. nursing home care
Because a medical emergency can lead to an eventual need for caregiving, your plan should include options and preferences for providing it at home or in a nursing home or other facility. If you’d rather keep a family member at home, consider the space you have or which you would have to modify or build to accommodate someone’s needs, the cost of retrofitting your existing living space by widening doors to accommodate wheelchairs and assistive devices, as well as simple things you’d need to install like safety bars in showers and tubs.

Create your family support system
It is also crucial for everyone in a family to decide who will be responsible for “care and feeding” when a family member needs it. To facilitate decision-making in larger families, one person needs to be designated in charge. But having a single point-person shouldn’t relieve all siblings, for example, of some measure of involvement in a parent’s caregiving, simply clarify lines of authority. Planning ahead will enable you to provide better care and allow you to feel and be in control when you are most likely to be overwhelmed and at the effect of events.

If you believe in an afterlife, when you and your family members reunite, they may give you an earful for having made their choices for you difficult because you didn’t even sign a living will. So, do everyone a favor and put your house in order; otherwise, even if you wind up in heaven, eternity could feel like a living hell. If you don’t believe in an afterlife, just be a mensch and write a plan.#