Living with stiff or arthritic hands can significantly diminish joy, confidence, and freedom. Among those over age eighty-five, about half of all women and one-quarter of all men are afflicted with the pain of osteoarthritis in the hands. To support your loved one’s independence, try these expert hacks and gadgets:

Equip the kitchen. Look for specialized grippers for opening containers: An electric can opener or spring-loaded scissors for opening food pouches. For carving or chopping, an electric knife or vegetable chopper. Choose tools, spatulas, and the like with cushy, large handles. Add “foam grip tubing” to utensil handles (also useful with pens, toothbrushes, etc.).

Modify the physical environment. Exchange doorknobs for levers or add slip-on, lever-style doorknob adapters. Install faucets with sensors that allow taps to control water flow and temperature. Try easier to grip, dimmer-style light switches. Go hands free with a robot vacuum!

Seek out adaptive devices and clothing. Look for adaptive “turning tools” to assist with keys and other small items. Purchase looser, slip-on adaptive clothing. Avoid zippers in favor of large buttons and elastic waistbands.

Update the computer. Add an ergonomic keyboard or try a table or touchscreen monitor for easier mousing and keyboarding. Easier yet, use voice dictation software whenever possible.

Add smart home features. Smart door locks with a keypad, voice activation, or biometric identification (fingerprint) can take the place of keys. The need to pinch and turn small dials can be replaced by smart lights and a smart thermostat coordinated by voice assistants such as Amazon Alexa. There are even smart stoves and ovens that can be controlled by a smartphone app.

Consult an occupational therapist. A home visit can provide tailored strategies and tools based on individual needs.

With the right devices and support, your relative can have a life that’s more manageable and less limited.

Does the person you care for have arthritis?
This disabling condition can make independent living painful and discouraging. As the San Francisco experts in family caregiving, we at Compassionate Community Care understand how arthritis can transform simple tasks into significant challenges. We have many practical ideas for addressing the limitations of this disease. Give us a call at (415) 921-5038.

If you are caring for a relative with serious health problems, you are probably in unfamiliar territory. For most of us, the shaky feelings of uncertainty are very unpleasant. We feel vulnerable outside our comfort zone. We worry we will do something wrong.

According to noted researcher Dr. Brené Brown, to protect ourselves we often turn to three strategies:

• Perfectionism. Believing that if we work hard enough, we can get it right.
• Future casting. Thinking about all the possibilities and things that could go wrong.
• Numbing. Pushing our feelings down and aside.

Although these strategies might help short circuit the discomfort of vulnerability, Dr. Brown warns that they also rob our lives of meaning. When we are vulnerable, we are emotionally exposed. This type of openness is frequently the springboard to life’s most meaningful moments: Changing careers, falling in love. In the context of family caregiving, it might be starting a difficult family conversation or caring for a relative in their last few weeks of life.

It is when we take risks and navigate terrain outside our comfort zone that we experience courage, growth, creativity, joy, and self-esteem.

Here are tips for embracing vulnerability as a family caregiver and getting to the other side:

• When you feel shaky inside, pause, take a breath. Consciously remind yourself that none of us is perfect. You are not alone. We are all worthy. All you can realistically ask of yourself is to show up and do your best.
• Consider feelings of uncertainty as an opportunity rather than a threat. Think of one step you can take. Something that feels a bit risky but not overwhelming. Maybe ask a question or ask for help. Or allow something to be done “well enough” rather than strive for perfection.
• Give yourself mental accolades when you have faced your fear. Many caregivers, in hindsight, take pride in the ways they had to grow to meet the challenges of caregiving. It takes courage to be open to change. Let it sink in that you have this capacity. And then take your next risk!

Are you caring for someone who is seriously ill?
That can be challenging indeed. You don’t have to do it alone. As the San Francisco experts in family caregiving, this is very familiar territory for us. We at Compassionate Community Care can walk beside you with education and support for those areas that feel daunting. Give us a call at (415) 921-5038.

Inflammation is the way the immune system attacks bacteria, viruses, and any perceived foreign agent in the body. It’s crucial when we need it! Think of inflammation as sending soldiers onto a battlefield. You need to fight the invaders, but also clean up afterward so life can get back to normal. As we age, our body’s ability to shut down an attack gets compromised. We don’t fight the battle as well. That means the inflammation doesn’t resolve. The body has not cleared out dead cells and other debris from the fight so new tissue can be rebuilt. Without resolution, the immune response keeps going. It’s harder for other cells to return to normal function.

To reduce chronic inflammation. The first step is to quit activities that provoke inflammatory response. Smoking and alcohol consumption, for instance, create unnecessary threats. Stress reduction techniques such as yoga or mindfulness contribute to health because they reduce the signals that the body is under attack. Weight loss is often recommended because fat cells produce cytokines, some of the warrior cells of inflammation.

Actions to support resolution (the cleanup)

• At least moderate activity 30 minutes a day, five days a week, helps flush the system and enhances DNA repair.
• Seven to eight hours of sleep a night gives the brain the down time it needs to tidy up and remove dead cells and the byproducts of inflammation.

Anti-inflammatory diet. While dietary changes may not eliminate chronic inflammation by themselves, they do support a healthy, resilient immune system.

• Avoid these foods. They tend to promote an inflammatory response. Trans fats. Fried foods. Sugary drinks or foods. White bread and pastries. Cured meats with nitrates (deli meats, hot dogs). All highly processed foods.
• Eat lots of these foods. They help get rid of dead cells and debris. Whole grains. High-fiber vegetables such as kale, spinach, and broccoli. Legumes such as beans and lentils. Anti-oxidant fruits such as blueberries, strawberries, and cherries. Fatty fish such as salmon and sardines. Nuts and seeds. Good fats from olives, olive oil, and avocados.

The Mediterranean diet and the DASH diet are examples of dietary practices that help reduce inflammation.

Are you concerned about chronic inflammation?
If your loved one has signs of or conditions linked to chronic inflammation (cancer, heart disease, dementia, diabetes, arthritis, autoimmune diseases), it’s wise to consider lifestyle changes. As the San Francisco experts in family caregiving, we at Compassionate Community Care know that isn’t easy. Give us a call at (415) 921-5038.

While older adults make up roughly 17% of the population, they constitute 22% of deaths by suicide. There are many reasons older adults might lean toward death: Poor health, chronic pain, loss of a spouse, loneliness, departure from working life, loss of independence, cognitive impairment. 

Warning signs. Any mention of wanting to die should be taken seriously. Also watch for depression. Withdrawal from social activities. Expressions of hopelessness (“Why bother?”) or worthlessness (“I’m just a burden”). Increased use of alcohol or drugs. Poor self-care and hygiene. Giving away belongings. Hurriedly changing a will or trust.

What you can do

• Ask if they are considering suicide. Asking will not prompt them to act. By asking, you demonstrate that they matter. Talk with them. Acknowledge their emotional pain. Find out more about their issues.
• Keep them safe. Ask if they have a plan. Do they have a timetable? Do they have access to their planned method? The more detailed the plan, the more likely they are to act. Ask them to promise you they won’t do anything for 24 hours.
• Be present. Gently ask how you might help. If you can ask them in person, great. If not, video conferencing and phone calls let them know they aren’t alone. Don’t promise things you cannot do.
• Assemble support. You can text or call the 24-hour Suicide & Crisis Lifeline at 988 to get advice. Also, help your relative identify others they can reach out to (a friend, counselor or faith leader, or the 988 Lifeline). The Suicide & Crisis Lifeline does not automatically send out first responders. They assess the urgency of the situation and work to diffuse the pain.
• Follow up. Call your loved one the next day to see how they are doing. Implement the suggestions of the 988 professionals. Encourage your relative to get professional support.

Are you worried about an older adult?
Let us support you. As the San Francisco experts in family caregiving, we at Compassionate Community Care understand how scary the prospect of suicide can be. You don’t have to do this alone. Give us a call at (415) 921-5038.

The original idea of “assisted living” was to give generally healthy elders a social option to offset the isolation of living alone. They were not intended to be medical facilities.

But things have changed in the 40 years since inception! Now, 41% of residents have dementia or moderate-to-severe cognitive impairment. One out of ten has a serious mental illness. More than half are 85 or older.

Assisted living communities are also experiencing staff shortages and high turnover. With a needier population, employees need far more specialized training than they did in the past. For dementia care, certainly. Also for infection control, as came to light during the pandemic. And end-of-life care. It’s hard to know which communities have adequately trained staff. 

Choosing an assisted living facility. If an assisted living facility seems like a good fit for your relative, your next step may be a Google search for available options. Placement agencies will offer “free” referrals. These agencies receive a fee from the facilities for bringing in a new client. They may only show you those that provide the highest fee. For objective recommendations, hire a Care Manager. They will assess your relative and give you suggestions based on the support your loved one requires and the facilities best suited to meet those needs. Also the ones with the lowest staff turnover and those that fit your budget.

When you tour a facility, be sure to talk to the frontline staff. Ask how long they’ve worked there and what they like about their jobs. Also ask about staff training offered through the facility. Look for clues in their body language that suggest their level of comfort about speaking freely.

Recognize that this may not be your relative’s last move. The median stay is 22 months. About 60% of residents leave to go to nursing homes. Others move in with family or move to a different facility.

Considering an assisted living community for your loved one?
Give us a call at (415) 921-5038. As the San Francisco experts in family caregiving, we at Compassionate Community Care understand what’s important to families. We know the local facilities very well—which ones have the best reputation and which have staffing problems.

We all need hope. It motivates us to get up in the morning and get going on the day. It makes our burdens less tiring. It’s even been documented to reduce anxiety and depression while improving health and quality of life.

Hope is not a blind conviction that everything will be okay.

Hope involves a process (often internal, unconscious). Hope requires having a goal, having options for achieving the goal (pathways), and believing in one’s ability to take meaningful action.

Hope is generally possible, but it may not be everything you want.

Hope for a cure in a cancer situation, for example, is a natural desire. But it’s not a hope you can make come true. Instead, convert it to something you can affect, such as having hope to make the treatment as easy as possible. Does your loved one have a hard time with chemo? Here you do have many options:

• Learn about the side effects.
• Be ready with remedies for nausea.
• Pick the best time of day for treatment.
• Find the easiest transportation there and back.
• Simplify daily activities and be patient if your relative struggles with the fog of “chemo brain.”

If you find yourself losing hope, examine what you are hoping for. Is it something you can influence? If not, revise your hope to something more within your ability to change. And if everything seems outside your reach—which happens often in caregiving—then make sure there is some other part of your life where you can achieve a desired goal. Make a plan and follow it so you can feel that at least one area of your life is under your control.

Does hope feel elusive?
You are not alone. As the San Francisco experts in family caregiving, we at Compassionate Community Care know how important hope is for keeping your spirits up. How tiring it can be when you feel hope fading. Let us help you bring realistic hope into your life. Give us a call at (415) 921-5038.

As a family caregiver, you have probably thought a lot about your loved one’s safety. Perhaps you have even purchased a wearable call button for medical emergencies.

But what if something happens to you? For instance, a car accident on the freeway? Or a trip-and-fall incident in a parking lot? How will emergency responders know that someone is depending on you for their health and safety?

A caregiver wallet card or bracelet provides a solution. A wallet card is something you can make at home. It can include more information than a bracelet. But it must be with you at the time of the critical incident. (Did you bring your wallet with you on your walk this morning?) An ID bracelet or necklace, on the other hand, can be worn all the time.

Information to include. At a minimum, your ID should state: “I am a caregiver. ICE, call [name, phone number].” “ICE” is short for “in case of emergency.” The idea is that this ID includes the name and phone number of an alternate caregiver who can step in. Of course, let your alternate know they are your backup and may get a call.

A more complete ID provides additional information:

• I, [your name], care for my [mother/father/aunt/spouse, etc.],
• [name of person you care for].
• Please call [name of alternative caregiver] at [phone number] to take care of him/her.

You might also identify your relative’s most critical medical need. For instance, specifying if they are an insulin-dependent diabetic, or have dementia, or are wheelchair bound.

Ideally, your relative might wear a similar ID bracelet or have a wallet card. This one would list their name and immediate medical needs. It would also list you as the first contact and an alternate if there is room.

Are you prepared if something happened to you?
Your support is critical to your loved one’s well-being. We can help. As the San Francisco experts in family caregiving, we at Compassionate Community Care have thought of all the potential problems and contingencies. You don’t have to do this alone. Give us a call at (415) 921-5038.

If the person you care for has generally good balance and needs just minimal support for getting around, a rollator (walker with wheels and brakes) might be preferable to a standard walker. Rollators enable a more normal, fluid stride. The features to consider start with size, weight, and foldability. If the rollator will be used outside the house, it must fit in the trunk of the car or behind the passenger seat. Is it light enough for your relative to lift themselves? Does it fold easily and to a workable size?

Another issue is the number of wheels and wheel size. The three-wheeled models are narrower and more maneuverable. This makes them ideal for indoors. Outdoors, wheel size is important. Small wheels don’t handle uneven paving very well (e.g., a sidewalk buckled by tree roots). A rollator with four large, fat wheels is less likely to abruptly halt or tip over.

Brakes are another concern. Will your loved one be walking up or down hills (even across the slope of driveways)? Most braking systems involve a hand grip that pushes a wedge into the tire, producing a quick stop. For downhill slopes, you want a larger brake that compresses a large part of the wheel and allows for a more gradual slow down.

Accessories are an important part of rollators. Does your relative need a seat, for instance? If so, is the seat for short rests, or would your loved one sit in the walker for a few hours at a time? If the latter, look for a seat with good cushioning. Other accessories often revolve around using the walker to carry items. Would a simple bag or a basket do? Is a cup holder needed? Or a tray for transporting a plate or bowl from the microwave to the dining table?

Some people get two rollators:

• For home. A three-wheeler with 6″ tires, wedge brakes, a hard seat (or no seat), and desired accessories. It can be heavier (20–24 pounds). Size and flexibility don’t matter.
• For outdoor uses. A three- or four-wheeler. Lightweight for lifting (13–15 pounds) and collapsible to fit easily into the car. Most important, you want large tires (8–10″) for safe walking on uneven surfaces. Wide tires and compression brakes reduce the chance of tipping or having the rollator go too quickly down a slope or driveway. A cushy seat may be the most essential accessory.

Consult with a Care Manager to find a physical therapist who can fit the rollator to your loved one’s size, weight, and needs.

Are you concerned about a loved one’s mobility?
As the San Francisco experts in family caregiving, we at Compassionate Community Care notice that a rollator can open up new options that are too difficult with just a standard walker. For these and other eldercare tips, give us a call at (415) 921-5038. You don’t have to do this alone.

The ability to handle one’s own financial affairs is critical to adult independence. Low vision challenges this freedom.

Fortunately, most banks are prepared to assist clients, whether banking online or in person. Online, your loved one can adjust the bank’s website for large print. Plus, many banks provide instructions on how to use a screen reader. Banks can also issue large-print checks and monthly statements in large print, braille, or audio versions. Some banks now have audio-accessible ATMs (and braille keyboards). By inserting a headphone jack, the ATM switches to audio mode. Consider a check template (like a stencil) for your relative, indicating where to write the date, payee, dollar amount, and signature.

To support your relative in storing and spending cash, look for a “low-vision wallet” with multiple compartments that facilitate storage by denomination. Folding bills will help your relative quickly identify what’s in their wallet. Keep ones flat. Fold fives in half to make something of a square. Fold tens in half lengthwise to make a skinny rectangle. Fold twenties twice to make a rectangle one-fourth the size of a normal bill.

To identify American bills, the Bureau of Engraving and Printing—the division in charge of printing money—created a free app, “EyeNote®” It scans bills and speaks the dollar value. Or when set in privacy mode, it pulses the value with vibrations or beeps. (One dollar is one pulse, two dollars is two pulses, five is three, ten is four, twenty is five ….)

When receiving money at the bank, have your loved one ask for bills all in one denomination, such as all tens. Or ask the teller to count them out in denominations (all the twenties together, all the tens together, all the fives …). This helps for storing and then folding appropriately when at home.

Are you concerned about a loved one with low vision?
As the San Francisco experts in family caregiving, we at Compassionate Community Care understand how important it is for visually impaired adults to maintain control of their money. There are support services, apps, and devices to help. Give us a call at (415) 921-5038. You don’t have to do this alone.

Has your loved one ever flatly rejected your perfectly sensible solution to their problem?

Though your idea may seem like the obvious route to take, it’s not so simple when you’re caring for an older adult. Your relative has had a lifetime of making decisions on their own. They usually want to continue doing so.

If you are having trouble agreeing, start with one simple principle:

Take your eye off the goal. Focus on the process instead.

We all want to be treated like people rather than like a project in need of completion. Much as you are concerned about the urgency of change, ask yourself if it’s really worth jeopardizing the trust and long-term communication you share with your relative.

• Involve the person you care for in decision making (assuming they do not have dementia). Do what you can to suggest a range of options so your loved one retains as much control as possible.
• Resist the allure of efficiency. Think in terms of teamwork. Coach yourself that the winning game plan is to go slow and steady. Sure, you could pick out an assisted living facility in a week. But without your relative’s buy-in, you likely won’t get cooperation for the move-in! Embrace compromise. Even if the pace seems too slow and the solutions are not ideal, it’s still progress.
• Honor their feelings. Aging involves so many losses. Acknowledge these losses during a private conversation. “Gosh, Dad, I can tell this is hard to swallow. What can we do to make it easier?” Your goal isn’t to become your parent’s therapist. But sometimes a demonstration of empathy is just what’s needed to melt resistance.
• Give it time. Make your suggestion and if you get resistance, let it rest for a while. Hammering on your points could easily prompt your loved one to become more entrenched. Let the idea percolate. After some time and reflection, your relative may find ways to make the idea their own.

If it truly is an emergency. It’s hard to watch parents struggling. We want to short circuit their distress or immediately reduce their exposure to hazards. But what seems urgent to us may not be to them. (And unless they are legally deemed incompetent, they have the right to make unwise decisions.) The threat to your relationship because you steamrolled an idea cannot be underestimated. If you truly think an urgent change is needed, get a second opinion from a professional. A physician. A Care Manager. Someone with training and experience in eldercare. They can give you an objective sense of how quickly action needs to be taken.

Are you worried about an aging parent?
We can help! As the San Francisco experts in family caregiving, we at Compassionate Community Care have a lot of experience working with families that are in the same situation: Kids see a definite problem and the older adult does not. Give us a call at (415) 921-5038. You don’t have to do this alone.