This past week the Boston Marathon bombings put parts of the city and suburbs on lockdown, providing an unwelcome example of a type of emergency families rarely plan for: terrorism and police actions. Most people who care for elders think often about the elder’s own health crises, and all of us have to plan for blizzards, power outages, and related events. But reassuing a frightened elder during an act of terrorism? Not so much.

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Congratulations to our own Dr. Deborah Bier, PhD!  The Home Care Association of America, the home care industry's largest trade organization, has asked her to deliver another of her popular series of webinars training professionals and families who are dealing with Alzheimer's Disease and Related Dementia (ADRD). In 2012, Debbie's first webinar was so popular that they immediately asked her to deliver three additional sessions on similar topics. We learned later that her sessions were being downloaded by agencies around the country to use in their training. Quite a compliment to her work, and a demonstration of the high quality we try to deliver at Caring Companion.

Debbie's trainings and webinars are based on a program developed by the Alzheimer's Association of Massachusetts and delivered through the state's Executive Office of Elder Affairs.  We use the approach, called "Habilitation Therapy," in training our caregivers for dementia clients.

Details of the webinar are below. 

Alzheimer's Disease and Related Dementias (ADRD) require a many resources to manage on a daily basis, draining caregiver energy, time, finances and patience. But there are proven methods to make care easier, safer, and more enjoyable for both patient and caregiver. Learn some of these little-known best practices, used successfully by both professional and family caregivers alike.

Deborah Bier, PhD, is the director of care for Caring Companion Homecare in Concord MA and has been a holistic psychotherapist for 25 years. Certified by the Commonwealth of Massachusetts's Office of Elder Affairs and the Massachusetts Alzheimer's Association, she trains dementia caregivers and coaches dementia families. Her particular expertise is in helping multi-generational families apply wellness approaches to managing chronic illness. She holds a doctorate in therapeutic counseling, and is a widely published writer and speaker specializing in health and healing.

Probably the single greatest reason we are called to serve families is to provide care following a fall by an elder. Particularly when people have lived in a home for decades, we see that homes and people have not adapted to the extra care needed to prevent falls. These are preventable events, and families with elders will be well-advised to attend Emerson Hospital's free workshop.

Falling - Don't let it happen to you or someone you love

“You’re never too old to improve strength and stamina,” I find myself saying to yet another new home care client at our first meeting. This time, it’s a delightful woman who is no longer able to care for herself. It’s not due to a specific disease or injury. It’s a generalized weakness and a loss of mobility developed over time that keeps her now from doing her own personal care, housework, and errands.

She’s lost her independence to a large degree because of too little walking, stretching, lifting, and reaching. As it common, she’s also developed a terror of falling, which keeps her even frozen to the couch – a fear that becomes a self-fulfilling prophesy, as more muscle loss causes greater unsteadiness on her feet. Surely this is the harbinger of some future fall if it’s allowed to continue in this direction.

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Yesterday I attended a presentation by Dr Gregory Martin, Chief Medical Officer of Emerson Hospital in Concord MA.  Dr Martin highlighted, with justifiable pride, a recent program by Emerson to reduce their already-low rate of hospital infection. Anyone familiar with current elder care issues at hospitals knows the concern that the facilities can be a petri dish of infection, and with frail elders and compromised immune systems, the risk of becoming sicker in a place designed for healing is one of the frustrating ironies in today's health care world.

As a home care agency owner, I was particularly interested in his remarks about reducing infection for clients with catheters, since so many of our clients have them. 

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Karen Tannenholz works in our office, and last summer she faced the kind of sudden medical emergency we help many people through. Stressed families often imagine their circumstances are unique, but Karen’s story reveals threads common among many: feelings of growing confusion, helplessness, stress, anger, and even humor are all normal. Ultimately, deeper appreciation of each other can emerge as we navigate together through some of life’s most difficult passages. To hear Karen’s story, click 'Read More' below:

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I took a short break this afternoon, and when I tuned back into the world of news, I found that the expected winter storm Friday into Saturday was now being called a BLIZZARD WATCH!  Eighteen to twenty-four inches are being forecast with high winds. My goodness... 

We rolled into action to consider the safety of every shift change Friday and Saturday... will the roads the safe? Will it be snowing too heavily? How can we serve clients Saturday night and Sunday morning safely? We will work with families and caregivers to create a plan for any shift changes that may be made unsafe or impossible by this storm. We will be in touch wiht impacted families and caregivers.

In the meantime, this is the right moment to share two blog posts I wrote from a past winter storm/blizzard. They contain info about prepping clients' and the caregivers' homes, and other important information. Please review this and then get into action to get ready.

Who Will Shelter Your Elder Loved One in an Emergency?
http://www.caringcompanion.net/blog/view/1873-who-will-shelter-your-elder-loved-one-in-an-emergency

First Possible Winter Storm Coming, Eastern Massachusetts 
http://www.caringcompanion.net/blog/view/1163-first-possible-winter-storm-coming-eastern-massachusetts

Easten Massachusetts Winter Storm Forecast Upgraded To a Blizzard
http://www.caringcompanion.net/blog/view/1177-eastern-massachusetts-winter-storm-forecast-upgraded-to-a-blizzard

Readers and others often ask us how to start conversations with parents about planning for the parents’ potential care needs and other aspects related to their declining capabilities. As we approach the holiday season, this is an especially good time to have these conversations – key family members who may be available only during holidays are often present, and it may be easier, even given holiday activity, to find some time for a quiet conversation. In hopes of facilitating a successful discussion this holiday season, we offer a few thoughts about what needs to be discussed, and how to conduct a conversation with an elder family member to plan for a time when he or she may not be able to manage independently.

First, as you approach the conversation, you will typically find best success if you think of it as

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Intro to Habilitation Therapy for Alzheimerʼs Disease &
Related Dementias

Habilitation Therapy (HT) is considered by the Massachusetts Alzheimer’s Association to be the best caregiving practice that exists today. Learn about this comprehensive behavioral approach that will help both dementia patient and caregivers alike, which can help improve their quality of lives dramatically. HT helps difficult symptoms be reduced or eliminated, regardless of what stage of the illness the patient is current experiencing, by skillfully adapting to the capacities of the patient and communicating accordingly. Habilitation Therapy helps caregivers have positive and successful interactions with dementia patients, reducing stress, allowing greater enjoyment of each day.

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Note: The following was published in our monthly column "Living and Loving: Elder Care in the 21st Century" in Gate House News' Concord Journal.  We will continue this theme of Alzheimer's and dementia in this blog with periodic articles on the subject.

The weeping elderly woman is pleading. “I want to go home! Please find out why my ride isn’t here!” Exasperated, her daughter snaps at her, “You are already home, mom! I keep telling you, why can’t you remember? You moved in with us last year!” More weeping, snapping, pleading and exasperation follow. Around and around this goes, several times a day. Both women end up beside themselves with frustration, sadness, anger, and fatigue.

While looking at books at their local library, a man suddenly jumps to his feet, announcing loudly to his wife, “I have to go to the bathroom, now!” Five seconds later, he wets his clothing, urine puddling around his feet. “I asked you to go before we left home and you refused! Why can’t you control yourself?! I can’t take you anywhere like this!” she says to him in despair and exhaustion. They are both embarrassed and ashamed, a wedge stands between them and tension hangs thick in the air.

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A recent blog post addressed how to conduct difficult conversations with an elder whose skills may be declining, but who is still  clear-minded enough to reason. Today we discuss territory where you often must act more independently, because Alzheimer’s Disease and Related Dementia (ADRD) has compromised your loved one’s ability to choose wisely. This is thorny territory.

This situation reinforces the importance of our focus from last column: Start these conversations before they are needed. By the time Alzheimer’s or dementia strike, elders are at risk of making decisions that put them in danger they do not recognize.  Advanced age and even the appearance of dementia are not a license to remove all sense of independence from the elder, but the family must be willing to

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The National Private Duty Association (NPDA) recently asked us to present a webinar for a national audience of both professional and family caregivers to discuss the Habilitation Therapy curriculum recently developed by the Commonwealth of Massachusetts and the Alzheimer's Association.  I was certified in the first class given using this curriculum designed to help people managing Alzheimer's Disease and other related dementias.  The reception to our presenation was so good that the NPDA has asked us to present a series of three more webinars on the topic. We will post details on those as soon as they are scheduled. 

You can watch and listen to our webinar on Habilitation Therapy for Alzheimer's at your convenience.  Fill out the simple registration form to proceed.

Caring Companion Home Care of Concord, MA was selected by the industry's most prominent national trade organization, the National Private Duty Association (NPDA), to deliver a consumer seminar entitled "When Dementia Strikes: Managing Care and Making the Most of Each Day."  It will be delivered as a free webinar on May 16 at 3:30 PM EST.

Alzheimer's Disease and Related Dementias (ADRD) cause grief for families and increasingly complex cases for home care agencies. The Alzheimer's Association and the Commonwealth of Massachusetts have developed an innovative new program to train family and caregivers in the use of Habilitation Therapy to reduce the care challenges in these difficult cases.  Participants will learn about best practices in the industry as the country faces this growing challenge.

"We are truly honored to have been selected to deliver this information, among the roughly 17,000 thousand homecare agencies nationwide," says Caring Companion owner and long-time Concord resident, Jim Reynolds. "We owe this to our Concord office director, Dr. Deborah Bier, who has become a recognized expert on dementia and home care." 

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Capacity is limited. Reserve your Webinar seat now here.

Alzheimer's Disease and Related Dementias (ADRD) cause grief for families and increasingly complex cases for home care agencies. The Alzheimer's Association and the Commonwealth of Massachusetts have developed an innovative new program to train family and caregivers in the use of Habilitation Therapy to reduce the care challenges in these difficult cases. Come learn about best practices in the industry as we face this growing challenge.

Bios of Presenters

Dr. Deborah Bier has been certified to train dementia caregivers and coach dementia families in Habilitation Therapy -- an approach recommended by the Alzheimer's Association that serves as the basis of a cutting-edge program recently developed by the Alzheimer's Association of Massachusetts and the Commonwealth of Massachusetts. As District Director of Caring Companion Home Care, Dr Bier was in the first class certified in this new program. She has a 25-year career as a counselor and agency director helping multi-generational families apply wellness approaches to managing chronic illness.

Jim Reynolds, CEO of Caring Companion Home Care outside Boston MA, has established CCHC as a leader in developing innovative technology and care solutions applied to elder care. CCHC has been praised for their unique proprietary family communications platform as well as its focus on wellness and use of Habilitation Therapy to care for ADRD clients.

After registering you will receive a confirmation email containing information about joining the Webinar.

New technologies to help seniors, the disabled and their caregivers are being launched every day. It's a huge, growing industry worth billions of dollars annually. But there are so many new products and services coming to market that most people feel confused and overwhelmed.  Do these devices mean  real aid for aging in place, or just a new way to part elders with their money?

Learn how to sort out the "toys and gadgets" from the helpful technologies on the market today. "Aging, Disability & New Technologies: Real Hype or Real Help?" Instructors Jim Reynolds and Deborah Bier, PhD will help participants make more wise choices in this bewildering, rapidly expanding marketplace.

The session will review some of the

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Sunday night I attended a workshop in Concord delivered by Harvard MA resident and hospice nurse Sue Dobbie.  Sue has spent 40 years as a nurse, primarily in home care and hospice, and currently works at Community Health Network in Holliston, MA, which provides nurses to home care and hospice agencies.

Sue led a discussion of the 5 Wishes document, which is published by Aging with Dignity. 5 Wishes helps families plan for terminal illnesses in a sensitive and thoughtful way, to be sure that the person who is dying can have the medical treatment and palliative care that he or she prefers, and that final ceremonies and wills can be arranged in advance, knowing that the person's wishes are being honored.

Sue mentioned how many families avoid discussing these topics, as if denial can delay or avoid the events. Unfortunately, studies show that we all get older anyway, and that denial is not an effective strategy to avoid death. Given that these events are coming, families always experience them more peacefully if they know they are caring for the terminally ill elder (or patient of any age) in the most sensitive manner possible, and according to his or her wishes.

The 5 Wishes asks five simple questions:

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Caring Companion Home Care has adopted and trains our caregivers in habilitation therapy when caring for clients with Alzheimers Disease and related dementias (ADRD). This approach was developed at the Massachusetts Chapter of the Alzheimer's Association, and is considered to be the best standard of care for all types of dementia. Sadly, it is not in as widespread use in all aspects of elder care as it should be.

Habilitation therapy is a comprehensive behavioral approach to caring for people with dementia. It focuses

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Recently I had the pleasure of breakfast with William O. Lytle, author of The Essential Organizer: An Ongoing Record of your Estate and Personal Information. Bill has created a valuable tool that helps families do exactly what it advertises -- a much-needed exercise.

Bill is pleasant, thoughtful, and friendly, and in discussing his work he tells stories of families he has interviewed in preparation for this publication. He talks about how difficult these end-of-life planning conversations can be, and had contacted me after a recent blog post on strategies to guide families through these waters before dementia strikes or other events make the conversation impossible.

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By Susanne Liebich (photo at right)

Editor's Note: This program is an excellent example of what we believe here at CCHC: that our clients are first and foremost people with challenges, not full-time patients.  The difference living this point of view is profound, as this article makes abundantly clear.

The healing power of dance… I stand here to vouch for its validity.  And in particular, I want to tell you about a technique called Dance for Parkinson’s Disease developed by Mark Morris Dance Group in 2001. This technique is not about therapy, yet it is therapeutic. It is not about exercise, yet for most, it is a wonderful workout using the whole body in different ways. Dance for Parkinson’s Disease is a pedagogy that integrates ballet with imagery, balance, mobility exercises, expression and enjoyment of the art dance. It’s about creating something aesthetically beautiful and creative with the body. It’s about appreciating dance for dance’s sake in a group setting and to explore the range of physical and creative possibilities that are still very much open to individuals with Parkinson’s.

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Download a flyer for this web conference here

Caring Companion Home Care of Concord, MA and the nonprofit National Private Duty Association (NPDA) will host a consumer education web conference entitled Depression and Older Adults – What Every Caregiver Should Know on March 13, 2012, at 8 p.m. EST. The live and interactive program will provide advice on how family caregivers can work with professionals to identify this condition and develop an effective plan of care for a loved one with depression. Caregivers will learn how to identify key issues and problems, locate needed experts and resources, and outline a plan to provide the best care for a parent. The event is free of charge and anyone can participate.

“Unrecognized, untreated depression is widespread among elders, who may present somewhat different symptoms, and who may need different types of treatment than younger people,” said Deborah Bier, PhD, director of the Concord office of Caring Companion. Bier holds a doctorate in therapeutic counseling, and has spent more than 20 years working with people of all ages with physical, cognitive and emotional disabilities. “Effective treatment can bring about an amazing improvement in quality of life and ability to function. This webinar is the type of increased public education and awareness that’s sorely needed.”

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