The dangers of cold weather are obvious outdoors. But there are dangers indoors, too, most often because the house thermostat is set too low. People can die from being too cold. Older adults are especially at risk.

Signs of low body temperature (hypothermia). Shivering is the body’s first response to cold. Later symptoms include stiff or slowed movement, slurred speech, sleepiness, mental confusion, or a weak pulse.

If your loved one’s temperature is 96 degrees or less, call 911 for emergency assistance. While you wait, make sure the person you care for is dry. Cover him or her with a dry blanket and offer a warm, nonalcoholic beverage.

The key risk factors for hypothermia

• Health conditions that affect blood flow, such as heart disease, diabetes, and stroke
• Medications such as sleep aids and major tranquilizers
• Lack of physical activity
• Alcohol consumption and/or inadequate intake of liquids (dehydration)
• Concern about finances and the cost of heating

The key preventives

• A warm-enough house. Set the thermostat to 68–70 degrees. Even a home temperature of 60–65 degrees can set off hypothermia  in an older person. Consider a thermostat that you can read remotely.
• Appropriate clothing. Many layers of light clothing trap body heat better than one heavy coat. If your family member is sedentary, consider adding a hat, mittens, or socks with fleecy slippers.
• Close doors to unused rooms. Also block drafts from windows and doors.
• Eat well and drink plenty of fluids. The body needs fuel to keep up its temperature.
• Consider a portable heat source. If you add a space heater in the bedroom or beside a favorite chair, be sure it is placed far from items that can catch fire.

Check in often to be sure they are doing well. Look for signs of hypothermia.

Options to reduce energy costs

• Add weather stripping around windows and doors. Hang curtains that keep heat in and cold out.
• Provide a personal heat source such as a hot water bottle or a warming bag that can be reheated in the microwave.
• For help with utility bills, contact your state’s branch of the national Low Income Home Energy Assistance Program (LIHEAP), or call the National Energy Assistance Referral (NEAR) project toll-free at 1-866-674-6327 for a referral.
• For help with making a home more energy efficient, contact the Weatherization Assistance Program.

Are you concerned about winter?
The cold weather is not easy on older adults. As the San Francisco experts in family caregiving, we at Compassionate Community Care can help you keep your loved one safe. Give us a call at (415) 921-5038

Take any roomful of people and likely two-thirds of them have relatives who aren’t talking to each other. Families are messy. Hurts abound. Some people wait until a serious diagnosis to reconcile. They often regret the years of separation they can never retrieve. Others try forgiveness earlier in the process. There’s no right or wrong. Simply who has the courage—and when—to either give or request forgiveness.

Giving forgiveness. Forgiveness does not mean you approve of what someone did. According to the Stanford Forgiveness Project, people forgive because they want to take control of their life story. Instead of seeing themselves as a victim laboring under significant hurts from the past, they decide to focus on what’s working in the present and the possibilities for the future.

Perhaps your parent was abusive. Or abandoned the family. Or was utterly self-involved. Whatever the cause, you experienced pain—emotional, and perhaps physical. The journey to forgiveness includes understanding (and accepting) that living involves pain. It’s what you do with your pain that makes you the person you are. Doubtless, your past has influenced your life intentions—for instance, deciding not to repeat the pattern. Embracing that goal, you can turn a negative experience into something more than grief.

You may come to accept that the person who inflicted the pain was likely in pain themselves at the time. Perhaps they were not as mature as they might have been. And maybe they even regret their actions now, years later. By extending empathy and forgiveness, you may find greater inner peace on your own journey. You have the opportunity to heal an old wound and maybe even create new and positive memories with someone significant from your past.

Asking for forgiveness. Perhaps it is you who did something unkind in the past and would like to reconcile. It takes courage to ask for forgiveness. The first step is to be honest about the relationship damage you caused. By all means be compassionate with yourself about your abilities at the time. But when talking to someone you hurt, just saying “I’m sorry” isn’t enough. Name and acknowledge your poor choices and actions that caused pain. Then ask for forgiveness. Expect to spend some time listening, humbly and attentively, as your relative shares their experience. At some point, you can ask, “How can we move forward together?” Your family member may or may not be willing. But at least you mended a part of yourself and your history and can move forward better on your own.

Are you ready to heal a relationship?
It’s never too late to initiate forgiveness. As the San Francisco experts in family caregiving, we at Compassionate Community Care are profoundly moved by the courage and grace we witness when a family member decides to prioritize their bond and find forgiveness in their heart. Would you like some help with this? Give us a call at (415) 921-5038.

The grandparent–grandchild relationship can be precious, like no other. But even young children notice if Grandma or Grandpa isn’t acting the way they used to, or the same way others do. And they will have questions. “Why does he keep calling me by Dad’s name?” “She just asked that question five minutes ago!”

Respond to them honestly. Keep it simple and age appropriate. Children under age two may feel scared. Reassure them. “Grandpa has a boo-boo on his brain that made that happen. He still loves you.” For those ages two to six, you might embellish: “Grandma has a sickness that’s affecting her brain and making it hard for her to think well.” School-age children (six to twelve) can understand that their grandparent has a disease that “messes up the brain, tangling all the thinking cells.”

Provide simple reassurance. All children need to know that the disease is not contagious and that their relative’s behavior is not their fault. You may need to remind them often.

Validate feelings. Your child may be upset by the unusual behaviors. They may sense your distress or be jealous of your attention. Let them know that sometimes you too are worried, even frustrated or angry. Give them the opportunity to share their feelings. Talk about healthy ways to cope. Check with a librarian for a helpful children’s book. If you notice acting-out behaviors or withdrawal from usual activities, consider professional help.

Suggest realistic activities both will enjoy. Maybe listening to music or singing. Planting flowers or weeding a garden. Doing arts and crafts. Taking a walk or sitting outside to enjoy nature. Looking at photo albums. Having a picnic. Storytelling. Holding hands.

Never put a child in charge to “babysit.” That is far more responsibility than they can handle. It’s not safe for them, nor for the person you care for.

Are children confused by Grandpa or Grandma?
Especially if they were old enough to develop a relationship before the dementia became apparent, children can be profoundly affected by the changes they witness. As the San Francisco experts in family caregiving, we at Compassionate Community Care highly recommend you address the situation candidly, especially if the person with dementia is a regular part of the childrens’ lives or affects household routines. Want help? Give us a call at (415) 921-5038.

If you expect older visitors this season, check your home for hazards. Older adults often have impaired balance and vision. This makes them prone to falling, especially in new surroundings. And fragile skin and bones can mean double trouble if someone does take a spill. Here are some tips:

Home entry
Early darkness and wet walkways can add to risk of a fall. Turn on outdoor lighting and make sure stairs have a sturdy handrail.

Living/dining areas

• Clear the floor! Store away toys, piles of books. Avoid slippery wax floor finishes and tape down area rugs.
• Eliminate extension cords from walking areas.
• Be mindful of fire hazards. If you’re plugging in an extra heater, place it at least three feet from anything flammable.
• Review seat height. Seating that is low, angled back, or lacks side arms can pose problems for elders. Add a firm cushion to raise the seat.

Indoor stairs
If your guest must use stairs, make sure they are well lit, without glare or strong shadows. Consider night-lights, and point out where light switches can be found.

Bedroom

• Install night-lights to light the path to the bathroom. Also provide an easy-to-reach bedside lamp.
• Check bed height. If it’s too high, provide a platform step. If too low, add risers. (These are sturdy plastic “cups” that raise each leg of a bed. Also useful for couch or chairs.)

Bathroom/kitchen

• Clear the floor! Remove throw rugs. Ensure pet bowls and toys aren’t underfoot.
• Avoid scald burns. Put red electrical tape on hot water knobs as a reminder to take caution. (Turning the water heater down is no longer recommended because bacteria can breed at lower temperatures.)
• Prevent slipping by placing a large, nonskid mat in tub or shower. A shower chair makes for a safer shower. Check the thrift store or borrow a neighbor’s.

Will older relatives be visiting?
It’s wise to give your home a safety once-over so your holiday is not marred by an injury. As the San Francisco experts in family caregiving, we at Compassionate Community Care can help you get oriented to the special needs of older adults—particularly if your loved one has dementia. Give us a call at (415) 921-5038. You don’t have to do this alone.

Taking the right medicines at the right time is extremely important to health management. But 75%­­–96% of older adults admit that they frequently make mistakes with their medication. Is your loved one among them?

There are many reasons why a person might not take their medicines as directed. “Forgetting” is one of the most common. But difficulty opening the bottle or reading the label can also result in medication errors. A pillbox can help, but choose carefully:

• Are there enough compartments? Are they big enough to hold all the pills?
• Are the compartment labels large enough to read (day of the week and time of day)?
• How snug are the lids? If dropped, might one pop open and the pills go flying?
• How finger-friendly are the lids? If your loved one has arthritis, a push-button lid may be better than one that requires prying to open.
• What about traveling? Would the pillbox be easy to take on a trip? What about pills needed if dining away from home? (Also consider adding a small pill dispenser to their key chain. These make emergency medicines, such as nitroglycerin, handy for your relative whenever and wherever.)

As for reminders, some pillboxes come with automated alerts. But this assumes your loved one is near the box when it’s time to take the medicine. Consider instead setting reminders on their phone or smartwatch.

One pillbox alternative is to work with a pharmacy that sends pills prepackaged with each packet stating, in large letters, its contents and when (day, date, time) to take the pills. If your relative’s medications do not change often, this can be a fine solution. Plus, the packets are good for travel (out for the day or for several days at a time).

Are you worried about medication management?
The more medicines your loved one takes, the more crucial this issue. As the San Francisco experts in family caregiving, we at Compassionate Community Care understand that medication management is one of your bigger concerns. You don’t have to do this alone. Give us a call at (415) 921-5038.

Deciding what holiday gifts to give a person with memory loss can be challenging. Following are some tips to share with family members.

The gift of time

• A special date to share cookies and send holiday cards to others
• Attending seasonal music events
• Caroling together

A person with early-stage memory loss is often still striving to do his or her usual activities. Gifts that provide reminder systems or simplify daily tasks are useful.

• A clipboard with attached pen for notes. Attractive stick-on labels for cabinets and drawers. An erasable whiteboard for listing the day’s activities.
• A push-button wristwatch that will literally “tell the time” out loud.
• A cell phone or personal alert system with a single button to request support from anywhere in an emergency.
• An automated pill dispenser.

A person with mid- or late-stage dementia thrives with simplicity. Even when words are failing, sensory pleasures can still be enjoyed.

• Music is almost always a hit, especially from the era of your loved one’s youth.
• Easy-on and -off clothes in soft fabrics, such as sweats. Shoes with Velcro straps.
• Cozy items for staying warm. A soft throw blanket, a fleece vest, or soft scarf. Even a furry stuffed animal as something to cuddle.
• Scented skin lotions for arms and hands.
• A robo pet. These lifelike pets can purr (or bark), tilt their heads, lift a paw, open and close their eyes, and respond to voice and touch. They have proven to be remarkably soothing for people in the later stages of dementia.

Are you caring for someone with memory loss?
As the San Francisco experts in family caregiving, we at Compassionate Community Care can help. It’s a big job and a very stressful one. You don’t have to do it alone. Give us a call at (415) 921-5038.

November is National Family Caregivers Month. We want to express our gratitude to you, who are part of the 40 million people (one in six Americans) who care for an older adult friend or relative. So many family caregivers feel invisible, we thought we’d give you some perspective on the scope of family caregiving across the country. For starters, only 4% of our nation’s seniors live in nursing homes. Another 4% live in assisted living, plus 5% in retirement communities. Most (46%) live in their own home or in the home of a family member (37%) or someone else (4%). They are assisted by an unpaid network of family and friends—caring people such as you—who drive them to the doctors, prepare meals, and eventually assist with dressing, bathing, and toileting.

The largest group of family caregivers provides ten hours of assistance per week. But 30% provide 20 hours a week, and another 20% provide forty hours or more. Yet many family caregivers don’t consider that they are essentially adding a part-time or even full-time job to their lives. Maybe you, too, think of it as “just what a good daughter/son, husband/wife/partner would do.”

Your contribution is not small! AARP has calculated that unpaid family caregivers provide 34 billion hours of care each year. That would be worth $470 billion if all were paid.

There are certainly rewards to caregiving. A feeling of gratification from giving back. Sometimes increased closeness with the person receiving the care. Pride in learning new skills. Greater compassion. Increased patience.

But family caregiving also has its costs. It can be demanding work. And family dynamics are often tough. Care receivers are not always grateful. Plus, there are often out-of-pocket expenses. Over $7,200 per year on average. Perhaps you’ve also felt that your health has suffered. Reduced sleep, minimal leisure time, delayed medical visits, and poor self-care are common. So are emotional consequences. More than one in three family caregivers reports high emotional strain. One in five reports feeling alone.

We salute you! As a nation, we owe an immense debt of gratitude to family caregivers.Thank you for all you do to help your aging and ill relatives. It does not go unnoticed by us! We are here to help.

Are you a family caregiver?
If you are providing assistance to an aging or disabled relative, give us a call at (415) 921-5038. As the San Francisco experts in family caregiving, we at Compassionate Community Care understand the challenges you face. You don’t have to do this alone!

Are frequent visits to the ER a significant part of the past six to twelve months? Does your loved one seem more fatigued? Less interested in eating? Perhaps a bit withdrawn?

These symptoms may be hallmarks of a serious illness your relative will overcome. But it’s also possible that these signal that your family member no longer has the reserves to beat their condition. We all get to this point in life. Still, it can be hard to grasp when it is your loved one at this juncture.

While we each have our own journey, there are common signs that a person is entering their final chapter. The medical term is “frailty syndrome.” Here are some indications:

• Multiple hospitalizations or trips to the ER
• Frequent infections
• Reduced appetite, weight loss
• Sleeping more, especially during the day
• Trouble with balance (falling), walking, and getting around
• Requiring assistance with bathing, dressing, eating, or toileting
• Withdrawing from activities and social gatherings
• Nostalgic reflection on the past
• Mental fuzziness or confusion

If you recognize some of these signs, it doesn’t mean your loved one is at death’s door. To gain perspective, consider asking the doctor, “Would you be surprised if [relative’s name] were to pass away in the next year?”

Difficult as it may be to hear, the doctor’s feedback offers opportunities for discussion and choices. Your loved one can consider how to live out the time remaining to them. At this stage, many people may decide there will be no more hospital visits. No more chemo. No more fighting the inevitable. However, they may still have goals they hope to achieve, relationships to mend, or simply want time to spend with family. One option for relief from taxing symptoms is hospice care. They provide symptom relief so your loved one can live fully in the time that is left.

Does your relative fit the picture of frailty?
As the San Francisco experts in family caregiving, we at Compassionate Community Care know how difficult it can be to acknowledge a loved one’s mortality. Hospice provides care and support for six months and even up to eighteen months or more. It’s never too early to ask. Give us a call at (415) 921-5038. We can help everyone consider the options and find ways to support the person you care for.

Is your family member seriously ill or in frail condition? A veteran? If so, the VA has a special service that offers palliative care to keep your loved one comfortable.

The cause of your loved one’s ill health is not important in requesting palliative care. The point is to relieve distressing symptoms. For example, you might be concerned about pain, nausea, or shortness of breath. Your relative can receive treatment specifically to keep such discomforts at bay.

Palliative care professionals work in a team, which allows them to treat the whole person. For instance, a social worker can address with emotional issues and a chaplain can address spiritual distress.

With palliative care:

• Providers come to the home. Or to a residential or skilled care facility or hospital.
• Your loved one may continue curative treatments.
• The focus is comfort and quality of life. The team works to make each day the best day it can be.
• Counseling support is also provided for family members, if desired.

Veterans who request palliative care can still receive treatment for curing the disease. For example, suppose your loved one has cancer. They can continue with chemo. The palliative care team would provide assistance for dealing with the pain of the cancer and the nausea from treatment. The team could also help with any emotional or spiritual issues. This support is available for the veteran and for the veteran’s family caregivers.

Palliative care is available to any veteran who is enrolled in the VA for health services. Most of the care is provided free of charge or with a very small copay.

Is the person your care for in pain or distress of any kind?
We at Compassionate Community Care understand how distressing it can be for you to see a loved one in pain or discomfort. As the San Francisco experts in family caregiving, we can attest to the value—for everyone!—of the relief provided by palliative care. Even if your relative is not a veteran, palliative care is not restricted to the VA. Give us a call at (415) 921-5038 to learn more.

Do you ever wish you could wave a magic wand for more joy? Patience? Optimism? Motivation? Maybe less irritability and stress? It’s actually accessible now, no wizardry required. Just a shift in attention. Welcome to “anticipation.”

You may have noticed that half the fun of a vacation is the anticipation of the journey beforehand. Research shows that anticipation gives people an emotional lift in the weeks before actual takeoff. Simply put, you can amplify the positives in your life by intentionally looking forward to them.

You don’t have to plan for a big expensive trip to get the benefits. Setting your sights on several small, near-term pleasures can deliver the same effect. It appears that the human brain can hold only so many feelings at once. Like a bucket. If you are anticipating several small pleasures—a phone call with a friend tonight, a delicious dinner tomorrow, a coming weekend off from your caregiving responsibilities—they start filling your bucket. This leaves less room for negative emotions and concerns.

Anticipating an experience delivers more happiness than looking forward to a material object. (Planning for a coffee date gives a bigger boost than planning to buy a pair of shoes.)

Plus, you can use anticipation as a motivator. Let’s say there’s a task you are not looking forward to, but you need to do it. (Drive your mom to visit her brother.) Mentally reframe it so that the drive is merely the “before” to the massage or a matinee you are planning as a treat after.

To leverage anticipation, all you need to do is make plans for something pleasant. Then give those plans prominence in your awareness. Why not try it now? Before you go to bed tonight, write down one thing you are looking forward to tomorrow.

Not enough joy in your life?
As the San Francisco experts in family caregiving, we at Compassionate Community Care know that time off to do things just for yourself can be hard to come by. In addition to anticipation, we know other strategies that can help you find more time for yourself and make the most of the time you have. Give us a call at (415) 921-5038.