A Place At Home – Merrimack Valley: Advocating for Seniors and Supporting Caregivers

In under a year, Gary and Arianna Lafreniere, owners of A Place At Home – Merrimack Valley, have provided over 7,000 hours of care to the families in the community and surrounding areas of Chelmsford, Massachusetts.

It’s a great start to their mission of helping people stay safe and healthy as they navigate the aging process. They opened their doors in February of 2021. The inspiration behind starting an in-home care agency is Gary’s mom. She was diagnosed with dementia in 2016. Gary and Arianna were both working full time and raising three young children. Gary remembers when the phone calls with his mom started becoming odd. She would request the same things over and over. When it first started, Gary and Arianna assumed she was becoming forgetful as she aged. They had no knowledge of dementia or what the signs were.

Gary says the day he knew it was something more was when she asked him when his birthday was.

The birthday conversation was the catalyst for a doctor’s appointment that eventually led to a dementia diagnosis. Shortly after that diagnosis, Gary’s mom suffered a fall. Fortunately, she was unharmed, except for a bump on her head. But she didn’t remember the fall at all. Gary clearly remembers thinking at the time how much he’d wished he’d known about the signs and symptoms of dementia before it had become so progressed in his mom. At that point, they knew it wasn’t safe for her to remain in her home. His mom lived by herself, and the family saw her often, but they couldn’t be with her all the time. They moved her into an assisted living community, and eventually, she was moved into Memory Care within the same building.

At the time, Gary and Arianna didn’t know what to do beyond that.

Gary shares, “Our knowledge of what could be done is that we’d have to hire a nurse, and we couldn’t afford that, knowing what a nurse would cost.” Back then, the couple wasn’t aware of in-home care as an option. Arianna says that if they’d known, that’s the route they would have started with. Having a caregiver in the home with Gary’s mom when they couldn’t be there would have provided safety and peace of mind. Fortunately, their experience was not a terrible one. Gary’s mom was safe and comfortable in the senior living community, and the staff that cared for her were genuinely invested in her happiness and quality of life.

“They treated her like she was their mother, and we really began to understand their job and gained an appreciation for caregivers from that perspective.”

The Lafreniere family with Gary’s mom

The experience with his mom was still on their minds later when the couple began considering what they wanted to do next, professionally. They knew they wanted it to be less about the money and more about helping people. They wanted something rewarding that would allow them to lay their heads on their pillows at night and feel good about their day. Gary says that opening an in-home care agency for seniors was the obvious choice. Arianna agrees, recalling the stress they felt when navigating the situation with her mother-in-law and the energy they’d put toward educating themselves and learning more about the disease.

“You’re kind of left to your own devices. You can research and find resources, but we really didn’t even know that in-home care existed for something like what mom had. So discovering that option really spoke to us.”

The couple decided to open A Place At Home – Merrimack Valley, and it couldn’t have come at a better time for the community. The COVID-19 pandemic was in full force. What might have been a daunting idea – opening a new business while businesses everywhere were struggling heavily or closing their doors altogether – ended up being a key reason that the Lafrenieres decided to move forward. Gary says they saw the need for home care in their community. Families who had been preparing for their loved ones to move into assisted living found themselves having to pivot and come up with other solutions that kept their parents and grandparents safer during the pandemic. Gary says they didn’t second guess their decision to open when they did.

“People were bringing their parents home, so they needed us. We never looked at it like, oh, this is bad timing. We just knew we had some challenges we would have to work around.”

Arianna recalls the research they did so they’d know what was needed for them and their caregivers to go into homes safely. They poured their energy into discussions with A Place At Home headquarters, understanding how other locations were handling the pandemic, ensuring they had proper PPE and safety protocols so that the clients and the families they served could be confident in the care of their loved ones. The public health emergency reinforced their desire to open their doors. “It was even more important for us to be up and running and available for those that wanted to bring them home.”

The experience with Gary’s mom left the couple with a desire to advocate for seniors with dementia and their families. In October, A Place At Home- Merrimack Valley were sponsors of the Alzheimer’s Walk. Money raised during the event goes toward further research of the disease that 55 million people live with worldwide. That day, the Alzheimer’s Walk raised half a million dollars. Gary says, “We’ll continue to be there every year, without a doubt. We were proud to be a part of that.”

A Place At Home – Merrimack Valley sponsoring the 2021 Alzheimer’s Walk

Now, Gary and Arianna advocate for seniors and their families on a daily basis.

Gary says the word they repeatedly hear when they meet with families is “overwhelmed.” Arianna remembers the sense of being overwhelmed herself as she made the initial phone calls, trying to figure out what to do and how to navigate the situation with her mother-in-law. But, she says now, owning an in-home care business, their experience has set them apart. They’ve been able to help and coach the families they come in contact with.

Gary agrees, sharing that more than anything, their experience with his mom inspired them to help people navigate the waters of “what do I do?”. Even if his mom had been able to stay in her home longer, eventually, she would have had to transition to Memory Care as her disease progressed. So now, when Gary and Arianna meet with families who are going through similar experiences, the couple’s focus is on listening to what the situation is, learning about what the family and their loved one’s needs are, and then offering advice and guidance that will best serve the senior’s health and quality of life. Often, that means providing care in their home. But, sometimes, that’s not a safe or sustainable option. In that case, the Lafrenieres help families navigate the process of finding an assisted living or memory care community that is better suited for their needs.

“That’s where we like to start, to ease that pain of being overwhelmed and give them the comfort of knowing that it’s something we can help with. It’s not something that we just researched. We lived it.”

Less than a year in, the couple is already impacting families in Chelmsford in a significant way. One of their clients is a couple who just celebrated their wedding anniversary. The family began to notice that their mom was struggling to care for herself. Their dad was in good health and helped as much as he could, but the family was at a point where they were considering their options. They either had to move their mom into an assisted living community – separating the couple – or they had to hire someone to come in for extra support.

Together, the family opted to bring care into the home, choosing A Place At Home – Merrimack Valley as their care provider. The decision has been a good one. The couple has grown close to their caregiver, and they recently spent time with their family and friends celebrating their anniversary in a way they wouldn’t have been able to if one of them was living in assisted living.

The effect in their community hasn’t just been with seniors and their families.

Gary and Arianna have profoundly rooted respect for caregivers. After seeing the compassionate way his mother was cared for, the couple is clear about where their priorities lie. Clients are their top concern – right along with their caregivers. Gary shares about their caregivers, “Their lives, their happiness, their jobs – are as much of a priority as the service our clients get.” And it’s not lip service. Gary and Arianna worked with a CNA school in their state to secure scholarships for caregivers that want to advance their careers.

The first caregiver to be awarded a scholarship is almost finished with the course.

When she applied to work with Gary and Arianna, she didn’t have any professional caregiving experience on her resume. She had, however, been a family caregiver for her grandmother. Recalling how the caregivers had treated Gary’s mom like their own, they knew she would be a good fit. At first, Gary and Arianna scheduled her with clients that needed a lower level of care. As her employment progressed, they put her through CareAcademy training to enhance her skill set. She caught on quickly, and because the Lafrenieres believe in investing in their employees, she’s on her way to being a Certified Nursing Assistant, advancing her career in the healthcare industry.

Gary and Arianna are happy to be able to offer support within their community. Chelmsford is where Gary grew up; Arianna grew up in a town 20 minutes north of there, and it’s where they’re raising their family. The couple is grateful to help the seniors and families that need extra support and invest in the futures and ambitions of their employees.

“It’s not just caring for the individuals that need this; it’s about the families in general. Knowing what we went through – the rewarding part is getting to allow someone to stay at home a little bit longer and stay comfortable and happy in their home, but you’re also helping the entire family.”

If you or a loved one are in the Merrimack Valley area and are overwhelmed and in need of support and care, you can find more information about the Lafrenieres and how they can help here.

Diabetes Awareness Month: Helping Seniors Manage Diabetes

November is Diabetes Awareness Month! As seniors age, they are more likely to develop diabetes. Diabetes is a chronic condition that causes high blood sugar levels and affects the body’s ability to produce insulin. Managing diabetes can be difficult for seniors who may have some degree of decreased vision or cognitive impairment. This blog post will provide caregivers with some strategies to help their loved ones better manage their diabetes.

Weight Management

Weight management is an important part of diabetes care because seniors who are overweight often have more difficulty controlling their blood sugar. In many cases, seniors with diabetes need to lose weight in order to increase the effectiveness of medications and improve overall health. Weight loss or management is achieved by increasing physical activity and reducing calorie intake from food sources. Encourage your loved one to eat healthy and participate in some form of physical activity every day. Our in-home care services for seniors in Albuquerque can help your loved one with healthy meal prep and light exercise. It can also be helpful for you to make lifestyle changes alongside your senior so they don’t feel alone while managing their diabetes. 

Medication Management

Seniors with diabetes often need to take medications in order to manage blood sugar levels. However, seniors who have decreased vision or cognitive impairment may struggle more than others when taking their medication. Encourage seniors with diabetes to keep their medications in a pillbox that has compartments for each day of the week. This will help seniors stay organized and ensure they are taking their medication as prescribed. 

Monitor Blood Sugar

Monitoring blood sugar levels is an important part of managing diabetes. Seniors need to check their blood sugar several times a day and record the results in order to help monitor and manage their condition. Seniors with diabetes should have a glucometer that is easy to use and read by those with decreased vision or cognitive impairment. 

Work With Doctors

Work with your loved one’s doctor to help manage diabetes. Their doctor can provide education and tools to help them better manage their condition. They will likely be able to give referrals for physical therapy and other services that can assist seniors in managing their condition. As seniors age, they often require more medical care, and their loved ones should be proactive in encouraging them to see a doctor for regular check-ups, especially since there are many seniors who may have diabetes but are not aware of it. If you need help with doctor’s visits, our Care Coordination services might be right for you! Our professional caregivers can attend doctor’s appointments, help manage day-to-day care, and refill prescriptions.

Reduce Stress

Stress can have a negative impact on seniors who are living with diabetes. Stress can affect blood sugar levels, medication effectiveness, weight management, and overall health. Seniors should try to reduce stress by participating in activities they enjoy or socializing more often with friends and family members.

Help Set Goals

Setting small goals that seniors can achieve on a daily basis can help them maintain control over their diabetes. This is better than thinking about long-term goals that seem too difficult to manage day by day. By setting short-term, achievable tasks, seniors will have more success in reaching those larger, far off goals, which ultimately helps them live an independent lifestyle in their own home.

In-home senior care services can be a good fit for seniors trying to manage their diabetes. We have compassionate caregivers in Albuquerque who can help with lifestyle care and care coordination. Schedule a free consultation or give our office a call at (505) 316-5440 today! We will quickly respond to your questions about our services, including senior living alternatives.

Lena and Edwin – Part 3

 

This blog is the third and final installment of the story of Lena and Edwin Michales. You can read about their early lives together here and the progression of Edwin’s dementia here.

Edwin was finally home from the adult behavioral health center. His medication had been adjusted. He was now taking 13 medications total, which Lena managed for him. He seemed to have leveled out. They were looking forward to the rest of the summer. Both had been vaccinated. They had season tickets to the symphony, and because few people were going out due to the pandemic, Lena and Edwin could go out to dinner without it being too stressful or triggering for him.

“We had a pretty good quality of life for where we were.”

Edwin’s dementia was still present in their lives, of course. The couple had six grandchildren they weren’t able to see due to the COVID-19 pandemic, and Edwin would ask Lena about how they were doing over and over again. He wanted to know where they were, if they were all healthy, and what was going on in their lives. Lena would answer him every time. She recalls, “We were very isolated because of the pandemic. So we couldn’t get out and see people, and that’s very difficult for a dementia patient.”

Even so, the couple was thriving as much as possible. Edwin still needed Lena to be near him at all times, but his moods and behavior were less volatile than they’d been. They would still sit on their deck in the evenings and look at the trees Edwin had planted all those years ago. Some days they would eat lunch at the park near their home.

Then, Edwin started complaining of back pain.

Lena took him to see their doctor, who ran some tests, and sent them home, telling them nothing was wrong. When his pain didn’t get any better, Lena took him back. She says they told her that they’d scanned him up and down, done x-rays, and couldn’t see that anything was wrong. They suggested he go to a rehabilitation facility to help him build up his strength. Lena says, “I thought, you know, they can’t find anything, so let’s try this. And he just steadily went downhill.”

Lena knew something wasn’t right, no matter what the doctors were telling her. She was frustrated with the entire situation. Because of COVID, she couldn’t see Edwin, and it seemed as though no one was taking her concerns seriously. It was the Occupational and Physical therapists at the rehab facility that finally listened to her. “I kept saying to them this just isn’t right. Something is wrong.” They agreed with her. They didn’t feel the issue was physical. They took a look at his medical records and discovered that Edwin had never had an MRI done.

“They’d told me that they’d run all the scans, that he’d been tested for everything.”

Lena hung up with the therapists and immediately called the social worker at the rehab to request that they order an MRI. During that call, she found out that Edwin had been on suicide watch for days. He was in so much pain; he was threatening to kill himself. No one had called Lena to let her know. She was furious, but she bit back her anger and told the social worker that she wanted Edwin transported to the ER right then and there. The social worker said that Edwin would have to wait another 5 or 6 hours before transportation was available. Lena did not swallow her anger this time. She told the social worker, “Call 911. If you don’t, I will. I want him in the ER now. Not in five or six hours.” Because Lena had medical power of attorney, Edwin was rushed to the ER. Lena met him there. She was walking down to the room they had him in when she heard Edwin screaming.

“Stop the pain, please stop the pain!”

Lena had never heard Edwin scream in all their time together. In the ER, they had to use fentanyl to control the pain, and they had to give it to him more than once. Lena spoke with the ER physician and requested that he order an MRI. The physician told Lena that it wasn’t possible; they don’t order MRIs in the ER because insurance companies deem them too expensive. Lena had had enough. She told the doctor, “Maybe it’s damn time you broke the rules!” Whether it was her fury or the pain Edwin was in, the ER doctor ordered the MRI. Then they were able to see it all. And it was too late.

Despite Lena’s pleading with his healthcare team that something was seriously wrong, Edwin had gone a month and a half undiagnosed with an infection that would end his life.

It was an infection he’d caught while he’d been in the hospital or rehab. He’d gotten it from either a blood transfusion, through an IV, or perhaps a catheter. By the time they found it, he had seven abscesses up and down his spine. The infection had spread to his pelvis, his bladder, and his stomach. The infectious disease doctor, his neurologist, and others on Edwin’s healthcare team were called in. For some reason, they decided to speak with Edwin without Lena present.

“I was so angry and very sad.”

They explained to him what it would take to clear up the infection. It would take months of IV antibiotics in a facility. He would not be able to come home, and they would have to get every single abscess. Edwin had a lot of them. He would have to have drains throughout his body. If he survived that, he would have to undergo more surgery to put titanium rods into his spine, fuse, and remove bone because the abscesses had already destroyed the bone. After all of that, he would have a two-year recovery. Because of the infection and his other conditions, the doctors would not say that he would survive any of it. In the end, it didn’t make a difference that they’d discussed any of it without his wife present. When they asked him how he’d like to proceed, he was clear about his wishes.

“Ask Lena. She knows.”

Lena brought Edwin home. She says, “This is where he wanted to be, right here. I promised. And I kept my promise.” They put a hospital bed in his favorite room – in addition to their home that was reminiscent of a log cabin. He called the room his “cabin in the woods.” The first week he was home, their great-grandchildren came to visit. Lena recalls the oldest, their 14-year-old great-grandson, sat with Edwin and held his hand. He spoke to Edwin and told him how much he loved him. After that, Lena says, “I couldn’t stay. I had to leave the room and let them be there by themselves.”

When asked about how she was feeling throughout all of this, Lena says she didn’t cry, and she didn’t get upset. Even when she lost her legs, she didn’t cry. She did what she had to do, and that’s how she approached things with Edwin. She says crying wouldn’t have solved anything. It wouldn’t have made him better, or moved them forward, or taken care of the house, or the bills, or the grocery shopping. And the whole time he was dying, she didn’t cry. He asked her one day after he’d been home, “Why do you look so serious?” And she told him, “Because I just want to take good care of you.”

Edwin lived 17 days after Lena brought him home.

After he passed away, Lena had a small service for him. Because of the pandemic, they weren’t able to celebrate his life in a way that they may have envisioned otherwise. Lena had been a teacher her entire life. Immediately after Edwin passed, her past students were some of her biggest supporters. Walking into their home now, you can see the stacks of letters and cards on the bar in their kitchen – all from students she’d taught over the years.

Lena says for a time after he passed away, she was still so angry. At how it all happened, and at Edwin. But one day, shortly after he’d passed, she was going through the drawers and files in his office. And she came across a photo album. It was full of pictures she’d never seen – pictures of her that Edwin had taken throughout their lives. She’d had no idea he’d taken them. Inside the photo album were images of Lena, living her life, while he loved her from behind the camera lens.

Finding the photo album dissipated a lot of the anger Lena had toward Edwin.

Now, months later, Lena is working to find a way back to herself. She was a caregiver for so many years. She says they were lucky – because Edwin was a veteran, they received respite care in the last weeks of Edwin’s life. However, she recognizes how impactful it would have been for her to have a professional caregiver earlier. “The thing that people need to be aware of, and that I wasn’t, is how badly I neglected my own health. My physical health, as well as my emotional health.” She’s started going back to church and says she may become involved in advocacy in the future, but for now, she’s back in physical therapy, “I need to get strong. That’s part of the healing, being able to do that.”

Lena and Edwin’s story is just that – their story. Unfortunately, however, worldwide, spouses are caring for their partners on their own, with very little support. Often, in Lena’s case, the primary caregiver neglects their own needs to their detriment. Asking for help can be difficult, especially with the stigmas surrounding dementia. But support does exist. If you or someone you know is struggling as a primary caregiver for someone they love, reach out to us. We would be honored to help.

Caregiver Burnout Prevention

The first step to being an awesome caregiver is caring for yourself. 

Caregivers sometimes feel overwhelmed with the responsibility of caring for their loved ones. They’re often providing support for someone else’s needs without recharging between tasks. This can lead to the feeling of being overworked and overwhelmed physically and emotionally—commonly known as burnout.

Caregiver burnout is a term that refers to the physical, emotional, and mental exhaustion experienced by stressed caregivers. It can lead to symptoms like depression or anxiety which make it difficult for them to provide quality care for their loved ones. Fortunately, there are ways to help prevent this from happening. Keep reading to find out how!

Signs of caregiver burnout

As a caregiver, you may focus on your loved one and overlook the toll that stress can take. It’s important to watch for signs of burnout.

  • Trouble sleeping too little or too much
  • Exhaustion that makes daily tasks difficult
  • Feelings of dread, guilt, being overwhelmed, or anxiousness
  • Easily agitated
  • Physical symptoms—headaches, stomach aches, getting sick more often, changes in weight
  • Withdrawing from people or hobbies you enjoy
  • Feeling disconnected from reality or that caregiving is taking over your life

Still unsure if you are experiencing burnout? Try this caregiver assessment from the American Medical Association.

Causes of caregiver burnout

Burnout is often the result of neglecting physical, emotional, and mental needs, but the following issues can also contribute.

  • Conflicting roles: When you become a caregiver, it can be difficult to separate your role as caregiver from other important relationships such as a parent, spouse, friend, or co-worker. You may find yourself neglecting other important relationships or letting them come second.
  • Unrealistic expectations: Caregivers often expect their care to have a positive impact on their loved one’s health, but this is not always realistic—especially for patients suffering from progressive diseases such as Parkinson’s or Alzheimer’s. Caregivers are also often overburdened—either by the expectations they’ve placed on themselves or by family members who demand more of them than they can handle. If you have an elderly loved one who needs memory care in Albuquerque, our specialized CARE programs can help.
  • Lack of control: Many caregivers find themselves frustrated by a lack of money, resources, and skills to effectively care for their loved one. It can also be overwhelming to feel like you had no choice in caregiving or that you have no privacy due to the time it takes to care for your loved one.

Preventing caregiver burnout

Caregiving is an important role that can come with the highest emotional and physical demands. It’s crucial to take care of yourself in order for you to be able to provide quality assistance when providing loved ones care. Now that you know what signs and causes to watch out for, here are some burnout prevention tips! 

Have realistic expectations and goals

Caring for a loved one can be an overwhelming experience. That’s why it is important to set realistic expectations, create daily routines, break down large goals into small tasks, or even just say no when requests feel like too much! Allow yourself to take breaks from caregiving, and share responsibilities with other family members. A Place At Home offers in-home care services 24/7 or even a few hours a day that can help share the load.

Accept negative feelings as a normal part of caregiving—it doesn’t mean that you’re a bad person or that your loved one needs more care, but rather it is a result of your overwhelming role. It’s normal to feel guilty at times, but know that no one is a perfect caregiver. You’re doing your best with what information and knowledge you have—even when things don’t go exactly as planned!

Support network

Create a support network for yourself consisting of family, friends, and your community. Communicate with family and friends about your loved one’s health and situation. Join a support group online or in your community with others who face the same challenges as you. Find resources for caregivers in your area such as transportation, food delivery, or housekeeping. A Place At Home offers in-home care for seniors in Albuquerque that can help make life easier.

Take time to build positive relationships outside of caregiving, especially with those who offer nonjudgmental emotional support. Create a time each week to do this, even if it is just a phone call with a friend!

Stay healthy

Don’t neglect your own health while caring for someone else. Set personal health goals and routines, and achieve them. Get plenty of sleep, drink water, exercise frequently, and eat a healthy diet. Remember to set your own doctor’s appointments and screenings. Talk to professionals—such as doctors, therapists, or social workers trained to counsel people in mental and emotional issues. 

Caregiving can be rewarding yet overwhelming, but you are not alone. A Place At Home offers compassionate senior-focused care. Whether you need daily in-home companion care, assistance navigating with health care options, or help finding a senior living alternative, our professional caregivers in Albuquerque can help. 

Schedule a free consultation today! You can expect an immediate response from our staff about any questions you may have.

Lena and Edwin – Part Two

This blog is the continuation of the story of Lena and Edwin Michales. You can read about their early years here. This is part two of their story.

Edwin Michales grew up poor in the mountains of Pennsylvania. It was something that Lena says he was always ashamed of, and now she thinks about how much of that contributed to the way his dementia presented. His father was a coal miner, and his mother rolled cigars in a cigar factory. Lena says Edwin never felt well-educated, and that’s because, in all honesty, he wasn’t. He lived in a coal mining community, and the schools weren’t great. When Edwin was old enough, he enlisted in the United States Air Force. One of his assignments landed him in a town on the East Coast, where he met Lena.

Throughout their lives, they traveled the world and eventually settled permanently in the Midwest. They both did work they were passionate about, and were raising two children surrounded by neighbors that were like a second family. They’d lived frugally throughout their younger years, planning to spend their golden years after retirement traveling more, visiting their children and grandchildren, enjoying their interests and hobbies. They often spent their evenings enjoying a glass of wine, looking out over their property and the trees Edwin had planted years before when they bought their house.

They both retired earlier than they’d planned to, at the age of 60. First, Edwin who was diagnosed with MS and found himself exhausted all the time. Then, Lena retired a few years later due to a cancer diagnosis that left her without both of her legs. Even so, they were both active, and were looking forward to traveling and more evenings on the porch. When Edwin first started acting odd, Lena chalked it up to the peculiarities of aging. “All of a sudden, he didn’t trust me to do his laundry anymore. I’d been doing his laundry for 50 years”. She noticed it more when his behavior became even odder.

“He would start following me in his car.”

Edwin became afraid that Lena would leave him and that every time she left the house, she was looking for a boyfriend. Whether she was going to a meeting or the grocery store, he was convinced she was searching for a new love. It was bizarre and nothing she’d ever experienced with him before. At first, Lena wasn’t sure what to think. “We had already been married about 50 years when this started, and I thought, he’s just being a fuddy-duddy in his old age. You know, you kind of put it off to that”. And she did put it off to that until his behavior became more intense.

“His behavior became dangerous – he would physically threaten me.”

It was when things wouldn’t work for him that Edwin would become upset. And it was always in the evening. Lena recalls the first time she felt threatened by him. He couldn’t understand how to use their new thermostat. It was connected by an app that they could adjust using their iPad. When Edwin couldn’t get it to do what he wanted it to do, he became furious. Lena would ask him if he wanted help, and she says you could see on his face that the rage was gathering inside him. He raged at her, telling her, “No! I don’t want your help!” before pounding on the wall as close as he could get to her head. Lena recalls thinking, “this isn’t good; there’s got to be something going on.”

Lena says that you could see how the anger in him was going to escalate into punching. She made an appointment with their primary care doctor, who advised her to tell Edwin he was coming in for his yearly checkup. While they were there, the doctor asked Edwin some probing questions and suggested that Edwin see a geriatric physician who could do further testing and maybe put him on medication to help. Edwin refused to make an appointment. Lena says that their doctor’s office told her that his behavior would not stop – it would escalate. And when it got to the point that she was physically in danger, she would need to be ready to call the police. That’s exactly what happened.

“It was when he came after me with the ax that I first took their advice.”

Lena says that the incident started because Edwin couldn’t get into his home office. They regularly kept the office locked with a key, and they both knew where he kept it. They stored his skeet and trap guns inside his office, and although those were in a locked cabinet, they often had grandchildren visiting and took extra precautions. One day, Edwin couldn’t find the key to his office. Lena went to where he usually kept it, and it wasn’t there. So, he had done something with it, lost it, forgot where he’d put it. But he became convinced that she had hidden it from him. His solution? To break the door down with an ax.

Lena didn’t realize that was what he was doing until she heard it. Weary and perplexed, she went to him and suggested they call a locksmith instead of breaking the door down. Suddenly, she says he yelled, “I should use this on you!” and came at her with the ax in his hand. In their home, you can still see the gouges in the walls, their bedroom door, and a side table, where he missed hitting her. Lena recalls thinking in the moment that she needed to figure out a way to calm him down. Luckily, she kept her cell phone in her apron at all times. She heeded the advice given by their doctor’s office and called the police.

The arrival of the police calmed Edwin down.

Lena explained the situation to them. They made an emergency appointment for Edwin at a Geriatric center in their city and told him that if he didn’t go to the appointment, they would come back and take him to jail. This threat of jail from uniformed authorities was enough to get Edwin to agree to an appointment. He was seen by a team specializing in geriatrics, including a psychiatrist, a social worker, a physician, and a group of nurses. He was diagnosed with dementia and put on a regimen of medications.

When asked if Edwin was aware that he had dementia, Lena says she thinks he knew, though he could never admit it out loud. She said he eventually adjusted to her being the only one that drove or paid the bills. In that way, she says, he knew he couldn’t do those things anymore, so he understood at some level. The change in him was heartbreaking. While Edwin didn’t have the best education growing up, he was self-taught. He was a voracious reader, and because he was so well-read, he had a vocabulary that would “knock your socks off.” Lena says he wrote beautifully and was a photographer, as well as an artist. His drawings are hung up around their home. He loved classical music, and Lena called him her “Renaissance Man.”

“He used to quote Marcus Aurelius to me when we were dating.”

As his dementia progressed, Lena lost more and more of the individual she’d had as her partner for over 50 years. Even with his medications and being seen by a team of specialists, she still found herself in physical danger from him. There were so many incidents, all fueled by paranoia, that had become a part of his reality. She says she lost count of how many times he would come at her for different reasons. One time, he had his hands around her throat and told her he could kill her. Another time, he broke a mug full of hot tomato soup over her head while she was ordering groceries online. “He was convinced that I had poisoned it.”

At the time, she didn’t know that he was also struggling with Major Depressive Disorder (MDD).

That diagnosis would come during an inpatient stay at an adult behavioral health center. Lena had him committed after he held a loaded gun to her head. There was a lot of violence that year. When asked how she felt at the time, having to commit her husband for the safety of both of them, she says she wasn’t feeling much. “By that time, I was numb to everything. I just did it.” While Edwin was there, they did brain scans and changed his medications. They found that his dementia had progressed to “moderate-to-severe” and that he had MDD. He was at the center for just under three weeks.

The professionals at the facility had wanted him to stay longer, but Lena was afraid for him to be there. She recalls that when she would be on the phone with him, residents there, especially women, would come and talk to him to try and get him to flirt. And when he wouldn’t, they would get violent with him. Lena was scared that Edwin would react by becoming violent back, though he never did. The incident that caused her to bring him home early? When he called her crying. Someone at the center had shown him the police reports – all of them – that had been made by Lena when he’d become violent with her. He called her, sobbing, asking, “Am I that bad of a man?” Because of his dementia, he didn’t remember any of that happening. They also told him he would become a ward of the state. Lena says she’s not sure who told him those things or why. She assumes it was part of his treatment. But she couldn’t stomach him being in that situation any longer.

“It broke my heart.”

Lena calmed him down and told him, “No, you’re not a bad man.” She called the facility after she hung up with him and told them she was bringing him home. And she did. They were both happy he was home, but that wasn’t the last time Lena would have to step in as Edwin’s advocate. Months down the road, in the middle of a global pandemic, she would have to do so again. This time, she would struggle between what the doctors were telling her and listening to her gut instinct that something was seriously wrong. Check in next week to read the final part of Edwin and Lena’s story.

Dementia is a tragic, life-changing disease that impacts not just the person diagnosed but the people who love them. If you or someone you know is struggling to care for someone they love, reach out to us. We can provide you with professional resources, support, respite, and care.

You can read Part Three of Lena and Edwin’s story here.

The Rings That Shape Our Lives – Stories from Those on the Aging Journey

Today is World Alzheimer’s Day – a day to raise awareness of the disease process that impacts so many seniors and their families across the globe. When in the throes of the disease, it can be difficult for loved ones to focus on much more than the loss they’re experiencing as they watch the person they love become unable to know where and who they are.

It’s true that as we age, a lot of us may experience certain conditions that impact what our day-to-day lives look like. Last month, we recognized National Senior Citizens Day. September is World Alzheimer’s Month. In October, we have World Osteoporosis Day. This seems to be a season of acknowledging older adults and the conditions that may impact them. But, these aren’t the things that define us. It’s our lives, our relationships, and the events that led us to where we are in our journey that define who we are, not our age or conditions. This month, A Place At Home is starting a new blog series – “The Rings That Shape our Lives: Stories from Those on the Aging Journey.” This series aims to reveal the identities of aging adults beyond their current care needs.

Like our logo, the Tree of Life, we all have roots that we came from, and the seasons of our lives have formed rings that tell the story of “us” – who we were, who we’ve grown into over the years, and who we are now.

Enter Lena and Edwin Michales, the first in our series. The Michales have been married for almost 57 years. She was a teacher; he was enlisted in the United States Air Force. They lived all over the world with their two children and spent time visiting the coasts when they were living stateside, and planned to continue traveling once they retired. But, unfortunately, they had no way to predict the way their lives would look at the beginning of their Golden Years. Cancer, MS, and finally, dementia would create some of the most profound rings of their lives.

This is the first part of their story.

Lena and Edwin met in a coastal town on the East Coast. He was in the military, and she had just graduated from college with a degree in Education. The first time they met was at a social gathering, introduced by a good friend of Lena’s. The next time the two would lay eyes on each other would be almost a year later, both participants in the same friend’s wedding party. Lena’s mother warned her to be careful with Edwin, telling her, “that man is looking for a wife, and he thinks he’s found one in you.”

As it turns out, Lena’s mother wasn’t wrong.

Edwin and Lena dated following their friend’s wedding, and though Lena’s parents weren’t supportive of the match, the couple knew that they wanted to start a life together. They approached the church, who told them that they couldn’t wed without their parents’ blessing. That didn’t stop them. The couple eloped and were married on December 26th. A week later, since they had been legally married already, they had a ceremony in the church. When asked which day they chose as “the” day to celebrate their anniversary, Lena says it was different each year. “If we were tired or broke on the 26th, we would celebrate it on the date a week later. We were often tired and broke on the 26th.”

Edwin and Lena were like most young military couples at the time. They had two young kids and a tight budget with which to afford life. When they were living stateside, Lena shares that they never went on extravagant vacations; they would rent a car, and travel to the East Coast, first to New Jersey to visit with her family, and then up the coast to Maine. Though they ended up retiring land-locked in the Midwest, the ocean has always been a theme of their lives.

“Almost every picture we took together over the years, there’s water in the background.”

There were years of their lives that they spent living overseas, living wherever Edwin’s military career dictated. Their favorite assignment was when they were stationed in Aviano, a town at the foothills of the Italian Alps, in Northern Italy. There was no base housing for this assignment. Everyone lived in the village or in farmhouses. They had no television and no phone. “I’d open my shutters in the morning to see the Alps – the Dolomites – to see what the weather was for the day.”

While Edwin’s time in the Air Force dictated where they lived, Lena found that, at times, it also dictated her career.

Growing up, she had a natural affinity for math and science. She was a voracious reader, as well. She read every single book in the children’s section of her hometown library. Once she’d read everything in that section, she got a note from her father that allowed her to read the rest of them. It’s no wonder she ended up going to college to be a teacher, a profession she loved and worked in until she was 60.

While they were living overseas, however, there were times when she wasn’t allowed to work due to restrictions put in place by the Department of Defense. They didn’t allow dependent wives from the US to work. But Lena was tenacious. She says while they were living in Italy, she would walk down to the piazza each morning where Civilian Personnel was located, telling them she wanted a job. Sometimes she went twice a day, every time being told “no.” Eventually, though, her determination paid off.

“They got tired of seeing me, and I finally got a job. I taught full-time, living in Italy.”

Educating children is something that Lena was passionate about when she was younger, and it’s a passion that remained with her throughout her life. She retired from the profession at the age of 60, but not by her preference. In 2002, she was diagnosed with cancer. It was in both of her legs. Though doctors did what they could, in the end, Lena lost both of her legs. Over six years, Lena underwent thirteen surgeries, each one leaving her bed-ridden for eight weeks at a time. Looking back, she says retiring was the right thing to do. She didn’t feel that she could do the job like she thought it needed to be done. Though she admits, it broke her heart to stop teaching.

“I still loved what I did, I still felt good, and I was fit. I had planned on working until I was 70. It didn’t work out that way.”

The tenacity that drove Lena through most of her life didn’t fail her when she lost her legs. At first, she was very dependent on Edwin, something that was a first for both of them. She was non-weight bearing and used a wheelchair. She was in and out of rehab facilities. Edwin was not only assisting Lena heavily, but he was also tackling things like grocery shopping for the first time in their lives together. TV dinners and Prego. “He took good care of me, but it wasn’t easy for him.” It wasn’t easy for Lena, either. She had always been an independent person, not afraid to carve out her path. Over their years together, if she wanted to travel somewhere and Edwin didn’t, Lena would go by herself. He loved her independent spirit.

Even after losing her legs, that spirit stayed with her.

Each day she would pack a lunch, and a van would come to pick her up from her home and take her to a rehab facility. There, she paid privately for the use of their gym and equipment to keep herself strong. After her workout, the van would pick her back up and drop her off at a local elementary school. There, she would spend the afternoon working with first graders. Lena volunteered at this particular school because it was wheelchair accessible, something she needed since she no longer had legs. Eventually, she was fitted with prosthetics, which allowed her to live far more unrestrained than she had been.

Lena remembers the relief she felt when her prosthetist told her she could drive with her new legs. “I became very independent again as soon as I found that out.”

Cleared to drive, she joined a book club in the city closest to her little town. She continued her volunteer work. She started a youth group that grew to be so popular, she had to start a waitlist for the kids that wanted to join. Lena had 33 fourth, fifth, and sixth graders at a time, giving back to their community. They would volunteer their time in homeless shelters, humane societies, hospitals, and more. Lena wanted to meet different people and didn’t want her life to be limited.

While Lena was rediscovering her independence in this new phase of her life, Edwin struggled with it. While her independence was something he had always loved and admired, this time, he seemed suspicious of where she was and upset that she wasn’t at home with him. At the time, she’d chalked it up to the idiosyncrasies of aging. He’d retired himself at the age of 60, diagnosed with MS. Though MS is a progressive disease, Edwin got along fine, for the most part, using just a cane for support. The worst of it was the fatigue it caused him, but even so, he had been able to care for Lena almost exclusively for the six years she battled cancer and through the loss of her legs. This new anxiety about where she was, was not like him.

“Now I look back at it, and it was telling that something wasn’t right. But I had no idea at the time.”

For the next few years, Edwin’s behavior and overall countenance would change so drastically that there was no way to brush it off as idiosyncrasies of aging. Lena would take on the role of Edwin’s caregiver, as he had cared for her when she lost her legs. Together, they would experience the confusion, sadness, and cruelty that dementia inflicts on families. Lena would learn how to interact with her husband in a way that she’d previously used when teaching small children. She would also come to know the significance of being an advocate, especially when Edwin’s disease progressed and he could no longer advocate for himself.

Life is made up of our stories. Our rings are what shape us. For the couple in this week’s series, they spent their lives doing things they loved. They remained each other’s support through it all. Their story reminds anyone who knows of it of the resiliency we all have inside us, no matter what life throws at us. Next week, check-in with us for more about the Michales and how Edwin’s dementia re-shaped their lives. You can read Part Two of their story here.

September is Healthy Aging Month

Healthy Aging Month is about raising awareness about how older adults can live healthier, happier lives.

The start of a new school year is the perfect time to celebrate Healthy Aging Month since people are motivated by back-to-school memories and are more inclined towards starting something new. Seniors are encouraged to stay healthy and learn new things that will improve their physical health and mental capacity during this month-long observance.

Keep reading for senior living tips to empower a positive outlook on aging and to continue to improve your life. 

Take charge of your health

Take charge of your health during Healthy Aging Month. Find out what benefits your healthcare insurance covers, and take the time to set up your annual physical and other health screenings, including examinations by your eye doctor and dentist. For most diseases, early detection can be hugely beneficial so remain diligent about your health, including taking medications as prescribed. If you notice anything unusual, don’t ignore it. While there’s no need to go to the doctor every time you’re not feeling well, know your body and what is normal for yourself well enough to detect if something might be out of line.

Exercise is important for healthy aging. If you are not accustomed to exercise, consult your doctor before starting an exercise routine and be sure to start slowly. Aim for 10–15 minutes of activity 3x a week and increase as time goes on.

Maintaining a healthy diet is also key to staying healthy. Obesity can lead to even bigger health concerns such as diabetes or heart disease. Plus, a slower metabolism means we need fewer calories when we get older, so it becomes increasingly important for us to reduce the amount of unhealthy foods we consume.
Additionally, our Care Coordination Services can help you and your family navigate the complex healthcare system. Our caregivers are not only an advocate for you, but can help with in-home health services. They can attend doctor’s appointments, coordinate with specialists, create a plan for day-to-day care, and pick up medication. We can even provide transition assistance for post-surgery or rehab, and a household safety assessment to avoid re-admittance.

Try new things

Don’t let your age stop you from trying new things (within reason, of course!). Get out there and experiment! Do something that will keep your mind and body engaged each day—it will give you something to look forward to. Here are a few ideas to get you started:

  • Try a new hobby
  • Learn a new skill or language
  • Read new books
  • Join a walking group

Working puzzles, taking up a new hobby like yoga, etc. can help reduce stress levels associated with aging problems. It’s good for both body and mind!

Stay positive

Studies have shown that positive thinking can help you live longer and more successfully manage stressful events. If negative thoughts plague your life, try to “re-train” yourself by replacing them with the silver lining in every situation. Try to be more pos­i­tive in conversation. When you catch yourself saying something negative, switch it around into a positive statement. Try not watching the news for a while to avoid negative reports. Surround yourself with energetic, happy people of all ages to help keep your own mood positive. Your mental health plays an important part in healthy aging, and surrounding yourself with people who make you smile and laugh makes it even easier.

Build a support system

A positive support system filled with friends and loved ones can greatly boost your mental wellbeing. Surround yourself with people who bring you joy rather than bring you down! Instead of feeling lonely and bored, reach out to your friends or family. Get together with them, invite them over for a visit, or even call them over FaceTime. 

Another asset to your support system is in-home senior care. Our in-home care services can be customized to fit your needs and keep your daily routines in the comfort of your own home. Our companions can help you participate in hobbies, help with socializing, and assist with your email and social media. They can also help you manage meals and nutrition, complete household chores, exercise or go outdoors, and provide transportation for errands. 

If you are looking for in-home senior care in Albuquerque, schedule a free consultation with our A Place At Home office. You can expect a quick response about pricing or answers to any questions about our in-home care, care coordination, or senior living alternatives. Our professionals are ready to provide you or your loved one with compassionate care, open communication, and support, and improve overall quality of life. Give our Albuquerque office a call at (505) 316-5440 or schedule your free consultation online today.

A Place At Home – South Portland Advocates for Inclusion in Healthcare

Jerome Philips, owner of A Place At Home – South Portland, is passionate about keeping seniors in their homes longer, with a better quality of life. That mission means providing his clients with safe and effective care and ensuring that his caregivers have a safe and inclusive environment with which to provide that service.

Over the years, Portland has struggled with racial and cultural disparity within its local healthcare system, making providing safe and quality care difficult. In the past, clients and other customers have had the option to say they don’t want care provided by someone with an accent or from a particular ethnic background. And healthcare agencies have had the option of accommodating those requests.

Cooperating with racially driven requests poses several issues. Inclusion, for one.

The first and most obvious issue is that of racism and discrimination in general. Allowing individuals to turn away caregivers because of their ethnic background perpetuates a cycle of unfounded inequity. It also impacts the quality of care that’s available in general. Caregivers are highly qualified and trained to do their job well, regardless of their background. And, from an employment perspective, it’s a problem.

“It’s a huge issue because it’s preventing those employment opportunities for entire communities.” Jerome shares that as soon as they opened their doors, they wrote policies against discrimination for his employees and clients. Even with those policies in place, it’s been necessary to express to some of his clients that they won’t make accommodations for them that are based on racial discrimination. And for families that are blatantly racist or hostile toward individuals? Jerome discontinues services.

“We do terminate services because we won’t make those accommodations. It’s not fair to our caregivers, and our caregivers know that we have their back, that we support them, and we’re willing to make difficult decisions so that they have a safe working environment.”

Thankfully, more often than not, once a hesitant family accepts a caregiver, they end up becoming attached. In Jerome’s experience, the situation goes from something the client may have found uncomfortable initially to a situation where they’ve formed a bond with that person and find comfort in the quality of care they’re being given. In addition, they find the caregivers are highly trained, efficient, and able to help in an invaluable way.

Jerome’s stance on these issues goes beyond how he operates A Place At Home. He’s committed to seeing a change from a higher level. He’s partnered with the Oregon Healthcare Association (OHCA). Together, they’ve advocated for their caregivers. They’ve had discussions with legislators at a state level expressing their concerns. “We’re talking to them and giving them very real stories because they really don’t understand what it’s like for our employees.”

OHCA has been a strong partnership, especially when it comes to fighting against racism and discrimination.

They’ve been long-time champions of DEI (Diversity, Equity, and Inclusion) in long-term care for clients and employees. They push for person-centered care that is personalized and culturally appropriate. They also push for nondiscrimination policies when it comes to hiring and employment practices. The state has a culturally robust population that includes members of nine native tribes and those who identify as Native Alaskans, American Indians, Pacific Islanders, Asians, Africans, African Americans, Latin, Hispanic, and Black. The state’s population also includes asylum-seekers, refugees, and DREAMers, to name a few. To push DEI interests, the state has issued new guidelines.

These guidelines require agencies to understand the effect that accommodating racially-driven demands has on the greater community.

Operating under the old paradigm undermines the quality of care available. However, the new guidelines offer hope if other agencies get on board. Jerome believes they will, even if that means they’ll have to decline care to those clients who won’t comply. Most clients, he believes, will realize that they can’t determine their caregivers’ race. So they’re going to have to become comfortable with the idea of inclusion. And he believes that agencies changing their practices when it comes to accommodating discriminating requests will positively change the experience of home care for all parties involved.

“If the whole industry enforces these guidelines, change will come.”

Over the last year, the pandemic has brought the concept of care in the home into even greater focus. As a result, several hospital systems are testing models of delivering care to patients in their homes. The idea is that treating people in familiar surroundings will produce better outcomes from a quality of life perspective. We need a skilled, effective, compassionate, and diverse workforce to provide quality care. Inclusion policies are key. Jerome and A Place At Home – South Portland are here for it.

A Place At Home has a mission to provide compassionate care to seniors where and when they need us. If you are passionate about making a difference in the lives of others, we want to speak with you. Reach out to us today to start making an impact.

Dehydration in Seniors: What to Look For and How to Help

There’s a heatwave throughout most of the country right now. With temperatures in the upper 90’s and higher, it’s an excellent time to make sure you know the signs and symptoms of dehydration.

Most people have likely been educated on the benefits of drinking enough water. Our bodies require it to function. For most people, drinking at least eight glasses a day is an easy way to care for ourselves. However, not drinking enough water can lead to dehydration, which can be detrimental to one’s health. The very definition of “dehydration” is “a harmful reduction in the amount of water in the body”. For most of us, that means we may feel sluggish, have a headache, or feel a little ill. 

For seniors, especially those with chronic illnesses, dehydration can be detrimental to their health and overall quality of life.

As we get older, our bodies carry a lesser volume of water at all times. This is a normal part of aging, and generally, getting enough fluids each day can mitigate the risk of dehydration. However, when aging adults become ill with even a minor infection such as a UTI, the risk of severe dehydration goes up. In addition, dehydration poses a significant threat in those diagnosed with chronic conditions, such as diabetes and dementia. 

If dehydration isn’t recognized early enough for a senior, the situation can become severe quickly. It’s beneficial and necessary to be able to identify things that can indicate a senior isn’t getting enough fluid in their body:

  • They may not urinate as frequently as they usually do
  • When they do use the restroom, the color of their urine is darker than it should be
  • They seem confused and disoriented
  • They feel dizzy
  • They’re more tired than usual
  • They are excessively thirsty

If you see any of these symptoms in a senior you love, there’s a good chance they’re dehydrated. If they have difficulty staying awake, have had diarrhea for more than 24 hours, or can’t keep fluids down, it’s time to call a doctor. 

Most of us are fortunate enough to take the ability to keep ourselves hydrated for granted.

However, for some seniors, their health conditions may constantly be working against them. As an example, they may be taking prescribed medications that can increase the risk of dehydration. In addition, some disease processes, like Alzheimer’s, can render someone incapable of recognizing that they need to drink water. Finally, for others, a disability may mean that they are physically unable to fetch their own drink. 

In some cases, a person may be utterly dependent on the help of other to stay healthy and hydrated.

Whether you’re a professional caregiver or caring for someone you love, there are some excellent ways to ensure the person you’re caring for is getting enough water:

  • Offer smaller amounts of water more often throughout the day – seniors can be hesitant to drink a lot at one time, depending on their physical and cognitive condition.
  • Encourage fluid-hearty foods at meal and snack times. Soup with a meal, or watermelon as a snack, for example
  • Water is the best, but an offer of tea, coffee, or natural fruit juice can encourage more fluid intake.

While the risk of dehydration is real for older adults, being aware of the things that signify that the person under your care isn’t getting enough water can help significantly increase the odds that you can address the situation before it becomes an emergency. Especially in those cases where the person isn’t able to take care of their needs themselves. If you or someone you know would benefit from having oversight so that they can stay healthy and independent, reach out to us to see locations near you. Our professional and compassionate caregivers are passionate about the care they provide, and we would be honored to help!

WISH Act May Change the Game When it Comes to Paying for In-Home Care

In news that could affect the care seniors receive as they age, the Well-Being Insurance for Seniors to be at Home (WISH) Act has been introduced in the U.S. House by Rep. Thomas R. Suozzi (D-NY). This new legislation seeks to help seniors pay for long-term care.

Currently, most Americans don’t have the coverage needed to pay for potential long-term care needs. This comes at a time when Baby Boomers are expected to have increased needs as they continue to age. Many rely on federal programs such as Medicaid. Medicaid covers nursing home care for seniors who have meager assets, and families are often faced with spending down their loved one’s assets to help them qualify. In most states, the threshold for assets is just $2,000.

Medicare, on the other hand, provides no coverage at all for long-term care.

Another current option is long-term care insurance. But only 2% of Americans have it, according to Time Magazine, partially because it’s expensive. As a result, their loved ones often try to provide a patchwork of care. However, these unpaid caregivers are untrained in most cases and often end up suffering from depression and stress-related disorders. In addition, many neglect their medical care as they try to provide care for their loved ones.

The WISH Act Provides Benefits and Flexibility.

As this new legislation seeks to help seniors pay for long-term care, it also gives them added flexibility. Instead of just funding nursing home care, the WISH Act would also allow seniors to use their benefits to pay for 6 hours a day of home care and pay for other services.

Monthly cash benefits would be about $3,600 and be indexed for inflation. The money would be funded by a .3 percent increase in the payroll tax for workers and employers.

Seniors who are of full Social Security retirement age and have significant cognitive impairment or need help with at least two activities of daily living (such as bathing or eating) could receive benefits under the bill. Once seniors pay into the system for 1.5 years, they would receive partial benefits. Full benefits would kick in after they contributed to the program for ten years.

Benefits under the new legislation would not be taxable. And seniors who receive benefits under the WISH Act would still be able to utilize other federal benefits programs. Funds from the WISH Act would pay out first, and then other programs, like Medicaid, could be used.

Find Out What Your Current Options Are

To learn about current options to pay for in-home care, find a location near you. We provide compassionate at-home care services that make it easier and safer for seniors to maintain their independence and continue to live at home.