If found early enough, many cancers can be kept in check. Some even eradicated. To encourage early detection, Medicare pays 100% (in most cases) for screening tests. Your loved one may have a copay and/or Medicare percentage for the doctor’s exam to administer a test. Or a  facility fee for a colonoscopy. To get the most insurance coverage for screenings, look for doctors who “accept assignment” (accept what Medicare pays). With Medicare Advantage, they all do.

Remember, a screening test is preventive care. It means no cancer has been found as yet. These tests look for specific indicators. If a cancer diagnosis is made, payment for follow-up treatment, doctor visits, and testing falls within your loved one’s regular Medicare arrangement. Deductibles or copays may apply.

To secure a screening test, get an order from your relative’s primary care provider.

• Lung cancer. Low-dose computed tomography (like a low-radiation X-ray). Medicare will pay for a yearly test for persons ages fifty-five to seventy-seven who don’t currently have signs of lung cancer. (Remember, this is for screening, not treatment.) They must also be a current smoker or have quit smoking within the past fifteen years.
• Colon cancer. Occult blood tests once a year for people age forty-five and older. A flexible sigmoidoscopy or a colonoscopy is covered once every two to ten years. (They involve a look inside the colon.) The frequency depends on your loved one’s risk factors and any precancer findings on previous tests. If the procedure is done in a hospital setting, there is no deductible required for the hospital, but the facility may bill for a copay amount. If a polyp is discovered and removed, this goes from “screening”—no problems yet—to an actual medical procedure. Your loved one may then owe a copay and, for original Medicare, the percentage that is the patient’s responsibility.
• Breast cancer. Mammogram once a year for women age forty and older.
• Cervical and vaginal cancer. Pap smear and pelvic exam, typically once every two years. If your relative is high risk for these cancers or had an abnormal Pap smear in the past three years, Medicare covers the test and doctor’s exam once a year.
• Prostate cancer. PSA blood test and/or a digital exam once a year for men age fifty and older. The blood test is covered 100%. There may be a charge if the doctor does a digital exam to look for an enlarged prostate.

Is your loved one resistant to screenings?
Who wants bad news? On the other hand, it’s great news if the screening shows no cancer. And if there is cancer, the earlier it’s caught, the better. Plus, cure rates are much higher than people think. Breast cancer, for instance, is the second leading cancer cause of death for women, yet current treatments result in a 90% survival rate. As the San Francisco experts in family caregiving, we at Compassionate Community Care can help you work with your relative to encourage them to get these screening tests. Give us a call at (415) 921-5038.

Tinnitus is often described as a ringing in the ears. But it can also be more of a clicking sound, a humming sound, or buzzing, hissing, or roaring. Ninety percent of people with the condition also have hearing loss.

Tinnitus is not a disease. Instead, it is thought to be the brain’s response to a lack of input from the ears. The brain then “tries harder” to catch the sound stimulation it expects. The result is internal noise. For many people, tinnitus is simply annoying. For roughly 10%, however, it can be quite distressing, interrupting sleep and concentration and bringing on depression and anxiety. Nearly one in four adults ages sixty-five or older experiences tinnitus.

If tinnitus interferes with daily life, talk to the doctor. There are several possible approaches.

• Address the underlying cause (if there is one). The culprit may be a buildup of earwax, which can be removed. Or, over 200 medications list tinnitus as a side effect. Aspirin and ibuprofen, for instance. Also, certain antibiotics, anticonvulsants, cancer drugs, antidepressants, and diuretics. Switching to a different prescription may help. Or hearing aids, because they deliver to the brain the auditory information it’s seeking.
• Mask the noise. A quiet room can make the buzz of tinnitus more distressing. “White noise” can provide neutral sounds to override the tinnitus. There are ear devices, even hearing aids, that can deliver white noise. If your relative has trouble sleeping, a white noise machine at night can help. A fan or air conditioner can sometimes do the same thing.
• Manage the reaction to it. Cognitive behavioral therapy can help your loved one live better with tinnitus. By learning new ways to think about the ringing, as well as relaxation and other coping strategies, your relative may feel less affected by the constant sound.

Does your relative struggle with tinnitus?
As the San Francisco experts in family caregiving, we at Compassionate Community Care often notice that hearing issues go unaddressed. Hearing problems frequently result in an older adult withdrawing from social interactions, which can then cascade into depression and poor quality of life. We can help. Give us a call at (415) 921-5038.

Once you decide memory care is the wisest path, the next step is choosing a facility and creating a smooth moving day. Many memory care communities have a “move-in coordinator” or other family liaison. Rely on this professional for guidance.

Ease the change with these tips:

• Involve your loved one in the choice of facility. Without saying why, visit each one with your relative. Have lunch there, perhaps engage in an activity. Watch how they respond and let that guide your choice.
• Wait to tell your loved one about the move. Avoid prolonged anxiety and confusion. Some experts advise that you wait until the day of the move to tell them, or when you are at the facility. Others advise no more than twenty-four to forty-eight hours before.
• Agree on “the story.” Everyone—family and staff—should say the same thing. For example, “The doctor says you need more than home care for your illness right now.” Even a fib (“The house is being tented for termites”) may be the most compassionate way to ease the transition. Imply it’s for a week or two, not a permanent move.
• Prepare logistics ahead of time. Ask the move-in coordinator what to expect, how the facility will greet your loved one, and how you will make your exit. Have a friend or family member bring photos and belongings over and set up the room before you arrive. You might want that person to spend time with you afterwards, as leaving can bring up a lot of emotions.
• The day of the move. Stick to routines as much as possible. When your relative understands what’s happening, stay calm and positive. Empathize. “This is hard for all of us. We just have to put up with it for now.” Stick to the message. Enlist the help of staff—usually a distracting activity—so you can exit quietly.

Is a move in your future?
As the San Francisco experts in family caregiving, we at Compassionate Community Care can help with insights and practical tips to smooth the way on this next step of your caregiving journey. Give us a call at (415) 921-5038.

A long-time hospice nurse—someone deeply committed to caring for the seriously ill—created this list of the top five deathbed regrets she frequently observed in her patients. She vowed to take these lessons to heart. Do any of these ring true for you?

• I wish I had lived MY life, not the life others expected of me. There’s no vitality in merely “being good” in the eyes of others. Doing things to please others will simply leave you feeling empty. Doing things that reflect your personal values will leave you feeling fulfilled. 
• I wish I hadn’t worked so hard. Between work and caregiving, are you allowing for quality time with people you love? What can you do to make more time available?
• I wish I had expressed my feelings more. It does take courage to let others know your thoughts and feelings. Such intimacy also adds meaning to relationships.
• I wish I had stayed connected with friends. What is cherished most in the end isn’t fame or money, but relationships. The priceless joy of being loved and giving love. Even with your time limited by caregiving, pick a few relationships to nurture.
• I wish I had let myself be happier. We don’t have choice about many things in life. But we do control what we spend our time thinking about. We can worry. We can be sad or angry. Or, instead, we can practice focusing on the things that ARE going well in our lives.

It never hurts to stop and take stock of your life. Use any regrets as a springboard for future action, bringing your deepest priorities and personal values to the fore.

Are you living according to your values?
As the San Francisco experts in family caregiving, we at Compassionate Community Care notice that family members have a unique opportunity to grasp the big picture. What does quality of life truly mean to you? Let us help you arrange your responsibilities so you can focus on what’s truly important in your life. Give us a call at (415) 921-5038.

If your loved one is admitted to a skilled nursing facility, Medicare requires the staff develop an initial, personalized care plan within the first 48 hours. This describes who should be doing what. Then, within the first 14 days, the staff must assemble a comprehensive assessment, which must include your loved one’s needs and strengths. Also their goals of treatment, personal preferences, and a brief life history.

Then, within a week, a formal care plan meeting of all the care team members—including your relative if they are able—is required, to develop a durable roadmap for care based on the assessment. As your loved one’s representative, you have the right to be involved in the plan and meeting.

The care plan lays out what services are needed to support your loved one toward achievable physical, mental, and psychosocial well-being. For example, physical, speech, or occupational therapy sessions. And it identifies dietary guidelines and food preferences. Overall, the plan must tie into and support your loved one’s stated goals.

Here’s how you can help:

• Before the meeting. Ask your relative what’s going well and what’s not. What do they prefer would happen? Help prioritize their questions and requests.
• During the meeting. Help the staff understand how best to communicate and work with your loved one. Keep your relative’s goals and preferences at the forefront. You can ask questions or request changes if you don’t understand or don’t agree with staff recommendations. Take thorough notes. You also have a right to a written copy of the plan.
• After the meeting. Monitor how the care plan seems to be working and definitely talk to staff if questions arise.

Build bridges with a collaborative approach rather than a confrontational mindset. If this sounds daunting, give us a call at (415) 921-5038. We can help advocate for your loved one’s wishes.

Has your relative been admitted to a skilled nursing facility?
If so, you have the right to participate in the care plan meetings and in the development of the care plan. As the San Francisco expert in family caregiving, we at Compassionate Community Care can help make sure your loved one’s needs and wishes are addressed. Give us a call at (415) 921-5038.

It’s important to do the best you can when caring for a loved one. But aiming for perfection can bring on problems. For yourself, in terms of anxiety, depression, and low self-esteem. And for your relative and other family members, who may feel burdened by living under the stress of constant measurement and judgment.

A desire to excel is completely honorable. But research shows that perfectionists actually get less done than other people. That’s because of black-and-white thinking. They see only the options of “complete success” or “complete failure.” That intense fear of failure results in an overfocus on details. What about gray? Maybe Mom did only some—not all—of her prescribed exercises today. That’s not failure; that’s a “good enough” day. If Dad snuck a shake of salt on his low-sodium diet, that’s not perfect, but it’s not failure, either.

Traits of a perfectionist. Do you recognize yourself in any of these?

• Unattainable goals. A perfectionist sets the bar unreasonably high. By contrast, greater success is achieved by starting with smaller goals and building from there.
• Outcome-oriented. A perfectionist focuses solely on the results, rarely the process. They live in fear of a flawed outcome. The alternative: Give it your best. Aim high, but also aim to enjoy the process.
• Judgment. Perfectionists look for flaws in their own achievements and those of others. And judge themselves harshly. Another approach is to honor what is accomplished, even if some goals fall short of ideal.
• Disappointment. A perfectionist is often disappointed. This frequently leads to depression. There is a more resilient option: Identify what worked and what didn’t and note what to do differently next time.
• Procrastination. Fear of failure can loom so large that perfectionists become paralyzed about moving forward. A success-oriented person understands that wins and losses are just a part of life. And you can’t win without daring to try.

If any of these traits feel familiar, don’t assume your standards are all wrong. (There’s that black-and-white thinking!) Consider broadening your focus to be success-oriented while appreciating the journey and the shades of gray between absolute perfection and absolute failure.

Think you may be a perfectionist?
You are not alone! As the San Francisco experts in family caregiving, we at Compassionate Community Care can assure you there are ways to curb your perfectionism and still make sure your loved one is safe. Give us a call at (415) 921-5038.

For many people, a pillbox is just the ticket. But as we age, we may take more medicines. Filling the box requires more concentration. Remembering to take the meds can become more challenging. Many families turn to technology to help an aging loved one.

There are two tech strategies: Reminders issued by a phone, and automated dispensers.

Reminder apps. If your relative does fine setting up the pillbox, try a smartphone reminder app. These require a lot of inputting, however, and updating as medicines change. Quite honestly, setting standard smartphone alarms to go off at the appointed time is much simpler and serves roughly the same function.

Automated dispensers. Although they aren’t very portable, if your loved one has memory issues and five medications or more, consider an automated dispenser.

• Filling the device. Some are like a pillbox and require a person (you?) to put the pills in compartments for each day and time. Then the machine beeps and opens the right compartment when its dose is due. Others allow you to load each medication in bulk into separate containers. One for each drug needed. The machine fills the individual day/time compartments based on what you have programmed.
• Reminder strategy. Some flash lights or make noise. Others send a reminder alert to your relative’s smartphone. Or make an automated call. Do you want to also receive a reminder?
• Confirmation strategy. Some devices keep beeping or flashing until the compartment has been opened. You can also have a “compartment opened” text confirmation sent to you. (No guarantees the pills made it into the mouth, however!)
• Protection against overmedication. Some devices lock the compartment when detecting that a dose of pills has not been taken at the programmed time. Again, you may want an alert when a medication is not taken.

Is medication management an issue?
As the San Francisco experts in family caregiving, we at Compassionate Community Care see families struggle with how best to ensure that their loved ones are taking what they need at the right times. Not too much. Not too little. Medication errors account for many older adult hospitalizations! If you would like help with this, give us a call at (415) 921-5038.

If you are the person most likely to step in if your loved one is unable to get to the bills—a hospitalization, dementia—you need to get oriented. And organized!

It’s easy to lose track of paperwork, especially someone else’s. Professionals recommend gathering important documents in a file or binder for safekeeping. Put that in a locked and fireproof location. Consider a small home safe. Or a safe deposit box at the bank.

Assembling this packet with your relative’s help ensures that you know about all the accounts that exist. (It’s never too early to put this information together. One never knows when a serious problem might arise!)

Following is a checklist of top-priority health and financial documents. Make sure you have the signed originals. Copies may not be legally accepted. 

• Original will or trust documents. These can also be kept at the lawyer’s office.
• Durable power of attorney for finance. This is a document. Confusingly, it’s also the title of the person named in the document to make financial decisions if your relative cannot. If you are the person gathering together important documents, you probably are, or should be, the durable power of attorney for finance.)
• Advance healthcare directive. This includes durable power of attorney for health and a living will describing preferred philosophy of care at the end of life.
• Ownership documents. Title and loan documents for property and vehicles. Also include documents for assets, such as savings bonds, brokerage accounts, and cemetery plots.
• Bank account information. Account numbers and login information. Don’t forget the key to any safe deposit box (and the number and the bank!).
• Autopay arrangements. A listing of services being paid automatically from each bank account.
• Insurance policies for life, disability, and long-term care. Get the full details, including policy numbers. Be sure you include policies provided by employers and any that were bought personally.
• Health insurance cards. Make a copy of the front and back of each card. You’ll want Medicare A/B, Medicare supplement if they have one, and Prescription Benefit Plan (Part D). If your loved one has Medicare Advantage, there is probably only one card.
• Pension and individual retirement accounts. A person who worked for several companies may have multiple 401(k) accounts. Check for multiple IRAs also.
• Debt and loan documents.
• Past tax returns. You need to keep only the most recent three years of returns.

If it feels awkward to approach your relative for such personal information, mention this article. You’re just following through on an important recommendation!

Are you the stand-in for financial tasks?
Finances can often be a sensitive topic. As the San Francisco experts in family caregiving, we at Compassionate Community Care can help you broach the subject of getting prepared in case you need to step in. Give us a call at (415) 921-5038.

Family meetings won’t cure old hurts or solve every current problem. But if they nurture teamwork, they can provide a solid foundation for the continued well-being of the person in need of care.

Creative solutions often emerge at family meetings, and the burdens of caregiving get redistributed in a more balanced fashion.

Tips for successful meetings

• Decide who should attend. Anyone with a stake in the situation should be invited, but keep it to fewer than ten people. Use technology as needed so that location is not a barrier and everyone can “attend.” Ideally, include the older adult. Consider a premeeting without them, though, to air feelings and establish roles (timekeeper, note-taker …). If the elder has dementia, family meetings may be too overwhelming.
• Create a safe space. Agree upon ground rules so everyone understands that all points of view are important and to be respected.
• Consider a facilitator. A social worker, therapist, or Geriatric Care Manager is trained in family dynamics and keeping group meetings courteous and productive.
• Agree upon overall goals. This is not about the past, but about the future. The point is to find a way to work together to do what’s wisest for your relative so their elderhood is as close to their desires as possible, given the circumstances.
• Set an agenda. Be realistic about what you can cover in an hour and a half. Determine who will be the timekeeper so everyone gets a fair share of time and the meeting ends when planned. You might begin by hearing each other’s assessment of the situation and any concerns. This may bring up a lot of feelings.
• Take notes. Ask someone other than the facilitator or timekeeper to take notes. The notes should identify concerns and the different tasks each participant has agreed to take on. Notes should be sent to everyone soon after the meeting.
• Understand there will be hiccups. When emotions are running high, many of us drop into childhood patterns of interacting. Acknowledge this challenge at the outset and ask that everyone aim to remain in their adult self. Also, forecast that no one is likely to get 100% of what they want. Try to be flexible and open to new ideas.
• Expect further meetings. If Meeting 1 focuses on concerns, Meeting 2 may explore solutions and Meeting 3, implementation. Consider touching base regularly after that.

Are all your family on the same page?
If not, let us help. As the San Francisco experts in family caregiving, we at Compassionate Community Care have experience working with families when members have very different ideas about what is happening and what needs to be done. Let’s start the conversation. Give us a call at (415) 921-5038.

If your spouse is younger than 65 and has received an Alzheimer’s diagnosis, you may feel in a world all your own. You probably don’t know anyone else in this situation and may sense a social stigma. It can be scary. Lonely. And feel just not fair!

Look for a support group. You are not alone. In a support group, you’ll find others who understand, as well as valuable tips and strategies. Check out the Alzheimer’s Association to find in-person, virtual, and hybrid groups. Try to find early-onset gatherings. (This is very different from “early stage.”) You might also check out WellSpouse.org specifically for caregiving partners.

Involve your friends. You need them now—more than ever. And yet they may feel uncertain of what to say or do. Let them know specifically what you need. Perhaps just someone to listen, let you cry when you want. Or maybe you need them to continue including you and your partner in get-togethers. Offer them guidance on best strategies for interacting with your spouse so they can feel more confident about what to expect and how to respond.

Find professionals to help. There are some big issues to tackle, and the time is now to work on them with your partner. A Geriatric Care Manager can help you understand what to expect and guide you as the disease unfolds. Consider the assistance of a therapist to get through sensitive topics with your spouse: Finances, sex, household chores, when to tell others, driving, end-stage care. Finally, work with an attorney to create legal documents for when your partner becomes unable to make personal decisions.

Early-onset Alzheimer’s is challenging and moves quickly. There’s no denying it. But you will experience less stress if you reach out early and often to get the support you need.

Does your partner have early-onset Alzheimer’s?
We can help! Call (415) 921-5038. As the San Francisco experts in family caregiving, we at Compassionate Community Care can provide you with an overview so you know what to expect. We can also provide age-sensitive support for your unique challenges. You don’t have to do this alone.