Are you noticing a persistent shake in your loved one’s hands, head, or voice? They might be dealing with essential tremor (ET), a common neurological condition that affects millions and typically appears after age sixty. The good news is that ET progresses slowly and isn’t life threatening. Tremors are usually the only symptom. But they can make daily tasks, such as eating and dressing, challenging for your family member.

Diagnosis
Diagnosing ET involves ruling out other conditions, such as Parkinson’s disease. Parkinson’s generally causes tremors when someone is at rest, while ET is more noticeable during action. Parkinson’s also causes slow movements and trouble with balance or walking. ET does not.

There is no one medical test that proves ET. To get a proper diagnosis for your relative, it’s best to see a neurologist. Ideally one who specializes in movement disorders. They’ll evaluate physical symptoms and may have your loved one perform simple movements. They’ll also review family history, because the condition is heritable. If you are unsure about the diagnosis, seek a second opinion. ET can be tricky to diagnose.

Treating symptoms
If your relative has ET, talk with their healthcare provider about options. In the early stages, learning what brings on tremors may be all that’s needed. As time goes on, the frequency of tremors may decrease, but their strength may increase. That can make it hard to hold objects. You might ask the doctor for a referral to occupational therapy. An occupational therapist can show your loved one techniques and devices to make their daily life easier.

If needed, the doctor may prescribe a medication, such as a beta blocker or antiseizure drug. Botox injections can also be effective. If these options aren’t enough, there are more-advanced treatments. In a future article, we’ll talk more about helping your relative live well with ET.

Is your aging loved one having tremors?
As the San Francisco experts in family caregiving, we at Compassionate Community Care have plenty of experience helping families navigate new diagnoses. Give us a call at (415) 921-5038 to learn more.

Did you say “yes” to being a healthcare decision maker for an aging loved one? It is an honor and a sign of trust to be chosen! And it is a powerful responsibility. As healthcare power of attorney (or proxy), your role is to make medical decisions for them if they cannot make them on their own due to illness, injury, or incapacity.

In this role, your job is to follow the Platinum Rule: Treat others the way they want to be treated. The decisions you make on your loved one’s behalf should match their values and priorities, even if they differ from your own. Even if doing so is emotionally challenging. Your choice should be the choice they would make if they could. For example:

• Your relative with advanced dementia now has pneumonia. If they indicated in their advance directive “don’t treat infection,” then you must refuse treatment with antibiotics—even if medical staff or family members press for it.
• Or perhaps your loved one is in a late stage of cancer that has relegated their life to bed-bound dependence. If they want to continue with treatment, it’s your duty to support them to that end. 
• Or your relative has a major stroke. Would they want to be kept alive no matter what? Say “yes” to a feeding tube? What would they say makes their life worth living?

Talk with your relative about their wishes before a crisis occurs! Make sure you understand their priorities. You might ask, what does “quality of life” look like to them? What would be worse than death? These are big, sensitive topics worthy of several discussions. Take your time and get details. There are various programs online that can help facilitate these conversations.

Check in with yourself, too. Be sure that you can honestly commit to advocating for the priorities your relative has identified, no matter what.

Finally, ensure that your loved one’s advance directive is up to date. Make sure it names you as the healthcare agent or proxy, if that is their intention. Then let the Platinum Rule be your guide.

Feeling daunted by decision making?
If so, we can help! As the San Francisco experts in family caregiving, we at Compassionate Community Care can help guide important conversations about healthcare decisions and prepare documentation. Give us a call at (415) 921-5038.

As a family caregiver, you probably hold yourself to a high standard. You expect yourself to react with kindness and patience at all times, no matter how unpleasant or inconvenient the task. Compassionate caring is a high ideal for family caregivers.

But some days are admittedly better than others. And then comes the self-criticism and guilt!

Here’s an idea, though: Treat yourself the way you would treat a friend. Research shows that people who treat their own distress with concern instead of judgment are physically healthier. They are also emotionally better able to deal with life’s inevitable setbacks. They stay motivated even when things are rough. For example, people who treat themselves with compassion

• cope with failure more productively. Rather than get upset, they consider the lessons learned.
• remain positive and motivated. They are less subject to fear, negativity, anxiety, and depression.
• take better care of personal health. They eat better, exercise more, and see the doctor regularly.

The next time you feel down on yourself, try a compassionate perspective. Consider your situation with

• kindness. You forgot to bring the list of medications to Dad’s appointment? Self-criticism will only make you feel worse. And it won’t make the list suddenly appear. Instead, patiently ask yourself what to do next.
• acceptance. You’re not keeping up with cleaning Mom’s house the way you envisioned? Give up the idea of perfection. It’s not humanly possible! Gently support yourself while continuing to do the best you can. Treat yourself with consideration, as you would a friend.
• awareness. You missed the party today because Dad wasn’t well? Of course you are disappointed! And maybe mad, or sad. Acknowledge your feelings in the moment. They are normal, natural. And like all feelings, they will subside. They just resolve faster when viewed as neither bad nor good, but rather, as a temporary experience.

Struggling with the role of caregiver?
That’s very normal! As the San Francisco experts in family caregiving, we at Compassionate Community Care know how to support folks like you through the ups and downs. Give us a call at (415) 921-5038. We are here to help!

As a family caregiver, your role is essential to your loved one’s well-being. But what happens if you get sick, injured, or face an emergency? Even if your relative is primarily taken care of by someone else, there’s also a chance that person may be unavailable at some point. Having a plan that identifies backup helpers ensures care continues smoothly for your loved one no matter what life brings. Here’s how to get started:

Identify a backup caregiver. Brainstorm who is local, available, and able to step in quickly. It might be a friend, neighbor, or another family member. Ideally, they are already familiar with your loved one. They also need to be reliable and able to stay level headed in an emergency.

The task doesn’t have to fall on one person; you can build a team of helpers. Confirm with your backup(s) that they’re willing to take on the role and be ready when needed.

Create a detailed plan. Whoever you choose, give them the information they need to take on the caregiver role. Collect information about your loved one’s

• providers: doctors, pharmacy, healthcare proxies, care manager, attorney, financial contacts, family members
• health: diagnoses, allergies, medication dosages and schedules
• routines: meals, sleep schedule, personal care needs, favorite activities
• legal documents: copies of important papers, such as durable power of attorney and healthcare directive
• local resources: preferred home care agencies, private care, respite care

Organize these details in a folder or binder to be kept in an easy-to-find spot at your relative’s home. If you are a long-distance caregiver, share the information via email. Go over the information with your backup(s) and address any questions they have. Review the plan monthly for updates.

Update your information. Especially if you are doing daily care, make sure you wear an ID bracelet, carry a wallet card, and under “ICE” (in case of emergency) on your cell phone, have a message that identifies you as a caregiver. Add your backup’s contact information.

With a solid plan in place, you’ll have peace of mind should the unexpected occur.

Need help creating a safety net?
As the San Francisco experts in family caregiving, we at Compassionate Community Care know how to put together a plan for care in emergencies. Give us a call at (415) 921-5038 to learn more.

Does caring for a loved one stir up some unwanted emotions for you? You’re not alone. While frustration may feel shameful to admit, it’s a common challenge in family caregiving. Think of frustration as the froth from deeper feelings brewing inside, such as disappointment, loneliness, anger, and stress overload. The key is to not expect that if you’re a “good caregiver,” you’ll never feel frustrated. Instead, learn how to keep those feelings from boiling over.

Examine expectations. When you’re caregiving, little is going to go exactly as planned. Maybe it’s time to take a look at your inner script and ease up on what you expect of yourself. Also, be realistic that your relative is doing the best they can, given their condition.

Preventative measures. It sounds trite, but it’s true: Taking good care of yourself can give you the patience and inner resources to better handle frustrating events. Build respite and meaningful activities into your schedule. Don’t skip meals, exercise, or sleep. Fatigue is a key trigger for frustration.

Reach out. Look for an outside source of support and understanding. This might be a friend, therapist, or support group where you can openly and regularly share your feelings. Having your feelings validated can do a lot to release pressure. And in the midst of a trying time, it helps to know that you are not alone.

When you’re aware of frustration bubbling up, consider the following:

• Pause and do a reality check
• Step away if it’s safe to do so
• Take ten deep, slow breaths
• Take a quick walk, if possible

By caring for yourself as much as you care for others, you’ll be better able to meet the challenges of the journey.

Struggling with frustration as a caregiver?
We understand! As the San Francisco experts in family caregiving, we at Compassionate Community Care can offer helpful solutions and resources to make your role a little easier. Give us a call at (415) 921-5038.

Misdiagnosis happens more often than you think, and it occurs more frequently for older adults than for others. There are myriad reasons why: Symptoms of many health concerns mimic or overlap those of other conditions, and older adults typically have multiple health issues. Disease symptoms can present differently in older adults. A medical professional may overlook symptoms, order a wrong test, misread results, or misattribute something to normal aging. And sometimes the symptoms themselves aren’t well remembered or are hard for the older adult to describe.

If your loved one is undergoing treatment but not improving, or if they have received a life-changing diagnosis, it may be wise to ask for a second opinion. This is not an outrageous or offensive request. In fact, it’s pretty commonly done. Here are some tips to help you advocate for your relative:

Listen to your instinct. If something about your loved one feels off, speak up! You know them best.

Talk to the primary care physician. Ask your relative’s doctor whom to see for a second opinion. Perhaps another local physician or an out-of-town specialist. Ideally, a geriatrician. You can also look online or ask friends and family members for a recommendation.

Go prepared. The more information about your loved one’s situation you can share, the better. Before you go, gather relevant test results, treatment plans, and prescriptions. Make notes to share about family history and new or worsening symptoms. Have medical records sent to the new provider. Bring a list of questions to ask. And send those questions to the doctor ahead of time, too. You might ask about prognosis and how they ruled out other diagnoses. Also, the risks, benefits, and effectiveness of the proposed treatment. And if any other treatments are available.

Stay attuned. If things still feel “off,” it’s appropriate to ask for a third opinion to ensure your loved one is getting the treatment they need.

Need help advocating for an older adult?
As the San Francisco experts in family caregiving, we at Compassionate Community Care know it’s troubling to have lingering doubts when your loved one’s health is faltering. We are very experienced with helping families navigate the medical system. Give us a call at (415) 921-5038 to learn more.

Home management of a chronic illness often requires the use of needles or lances. You may need to give your family member shots. Or draw drops of blood for testing.

All these procedures involve the use of what are known as “sharps.”

• Needles, infusion sets, and other systems for giving drugs or withdrawing fluids
• “Fingerstick” instruments for getting drops of blood
• Insulin pens and other prefilled devices for drug injection

The EPA estimates that every year more than 3 billion sharps are used in homes and other nonmedical settings.

A used sharp is a danger to people and pets. They can cause injury, creating an opportunity for infection. And they can spread diseases such as hepatitis and HIV.

• Never place loose sharps in a home or public wastebasket.
• Never flush sharps down the toilet.

If you poke yourself with a sharp, immediately wash area with soap or apply rubbing alcohol. Then call your doctor.

Always use a disposal container. Place used sharps in a container right away. If no container is available, recap the sharp for later disposal (be careful not to poke yourself in the process of recapping!). Leave containers only 75% full.

• FDA-approved containers. They are widely available online and through drugstores and medical supply stores. They are premarked with a “full” line. Some insurance plans and drug manufacturers pay for these containers.
• Alternative disposal containers. When necessary, use a heavy-duty, plastic household container. It should stand upright and have a tight-fitting lid with a small access hole. An empty liquid laundry detergent container is a good example. Label it clearly as containing hazardous waste.

Do NOT place a sharps container in the trash! Find out about container disposal options in your community from a local pharmacist, waste removal service, or city/county health department.

Need help managing your loved one’s health?
As the San Francisco experts in family caregiving, we at Compassionate Community Care have a lot of experience in coaching folks like you through the ins and outs. Give us a call at (415) 921-5038 to learn more.

If your loved one has Alzheimer’s or another dementia, you may wonder what you can do to keep their life lively and boredom at bay. There are likely more options than you realize! The first step is to reflect on your relative’s history and hobbies. They’ll engage best with activities that fit with their identity and feel meaningful to them. Ideally, activities that help them feel purposeful and included. Here are some ideas to spark your imagination, whether you’re looking for something playful or productive.

Leisurely activities
If you’re indoors: Do a puzzle; play dominos, marbles, cards; review photos; set up a toy train; dance to music; befriend a robot animal. If you’re outdoors: Go bird watching, paint flowerpots, walk in a park, take a drive or ride in a boat, name flower colors.

Tasks-oriented activities
Indoors, you can brush the dog, arrange flowers, organize books/magazines, sort bolts and nails, arrange jewelry box (or fishing tackle box), set the table, fold napkins/laundry. Outdoors, perhaps trim roses, plant flowers, sweep, or rake.

What’s appropriate will change as the disease progresses from early to middle and late stages. For example, if your loved one has been avid about golf, tennis, or basketball, they’ll be able to continue with friends for a while, then switch to just putting, or using a backboard, or using a single hoop. In late stage, make up simple ball games involving rolling or tossing. If your relative loved to cook, have them find recipes. Cook with them. Keep them engaged, but simplify tasks over time.

No matter what the activity, you will likely need to help your loved one get started and stay with it. Expect their attention span to shorten with each stage.

Alternatively, many communities have adult day centers or senior centers that offer daytime activities for older people. This is a great resource to keep in mind (and catch a break for yourself, too).

Need help with a loved one who has dementia?
We at Compassionate Community Care are the San Francisco experts in family caregiving. We understand your struggle and are here to help you problem solve. We can also recommend adult day centers and enrichment programs. Just give us a call at (415) 921-5038.

Heart attacks don’t always look like what you’d expect. While you might imagine a person collapsing with intense chest pain, that may not at all resemble what happens. It is true that the most common heart attack symptom for a man or woman is chest pain or discomfort that lasts more than a few minutes. But other symptoms can be subtle and—especially in women—may even be mistaken for the flu! Pay attention and act quickly if something seems off about your loved one.

Typical warning signs

• Chest pain and/or burning sensation
• Pain or discomfort in one or both arms
• Heart palpitations
• Shortness of breath
• Feeling weak or faint

Some less-typical signs

• Pressure or tightness in the chest (different from pain)
• Pain in jaw, neck, or back
• Dizziness
• Cold sweat
• Indigestion, nausea, or vomiting
• Unusual fatigue or insomnia

Symptoms in women
Women are more likely than men to have symptoms unrelated to chest pain, such as fatigue, insomnia, and nausea. Women are also more likely to experience pain in the back or jaw. These symptoms can occur when resting or even when asleep.

Some symptoms may start days or weeks before the actual heart attack. If your loved one experiences any combination of these signs, seek help. If you suspect a heart attack, call 911. The longer the heart is without oxygen, the more damage occurs. Emergency responders can start treatment immediately. They can also prepare the hospital for your arrival, ensuring that care is provided quickly.

Concerned about your loved one’s heart health?
As the San Francisco experts in family caregiving, we at Compassionate Community Care can familiarize you with the warning signs to watch for. Give us a call at (415) 921-5038 to learn more. Let’s raise awareness together!

Creating a fire escape plan is smart for everyone but essential for older adults, who are at greater risk during a fire. Planning in advance can make all the difference.

Consider the living situation. Ideally, your loved one would live, or at least sleep, on the ground floor. If your relative lives in a high rise, ask management if there is an automatic sprinkler system. Notify them that your relative may need assistance in case of fire. In a facility, ask about emergency plans and how often they are practiced.

Use fire alarms. Ensure there’s an alarm inside every bedroom and on every level of the home. For those with hearing impairments, choose alarms with strobe lights or vibrating bed shakers. Test alarms monthly and verify that your loved one knows what to do if they hear that sound.

Identify two exits from every room. Check that doors and windows can be easily opened by older hands. Ensure that escape routes are free of obstacles and are accessible, even with mobility devices such as walkers.

Keep essential items nearby. Have your loved one keep glasses, hearing aids, phone, flashlight, and other basics on the nightstand for quick access. For any emergency, keep a grab-and-go bag with medications and other essentials handy and visible.

Decide on a safe place. Choose an accessible, nearby location where your loved one can wait for help.

Practice the fire escape plan at least twice a year. Try to practice both during the day and at night. Update the plan as needs change.

Communicate. Discuss the plan with neighbors, family, and any aides. Arrange for someone to be your relative’s nearby helpmate. If they have a medical alert device, share the plan with the company. Review the plan with the local fire department. Ask if they can keep information about your loved one’s needs on file or can flag their address in the dispatch system.

Need help planning for the unexpected?
As the San Francisco experts in family caregiving, we at Compassionate Community Care are dedicated to helping you protect the well-being of your loved ones. A well thought out plan is key to staying safe during emergencies. Give us a call at (415) 921-5038 to learn more.