Don’t you just somehow feel better when you laugh? It turns out, that’s not just fantasy.

Laughter has physical and emotional health benefits.

Studies show that laughter can

• support the heart. If we’re laughing, we’re not stressing. The stress hormones make chronic inflammation worse and threaten the heart. Laughter stimulates your heart and lungs in good ways, bringing oxygen and reducing the stress response.
• relax muscles. Good, deep breathing is part of laughing. It stimulates oxygen flow to the muscles and triggers muscle relaxation.
• lessen pain. The body’s natural pain-relieving hormones, the endorphins, are released when we laugh.
• boost immunity. Laughter helps combat infections and other diseases by releasing neuropeptides that help fight stress and potentially more-serious illnesses.
• ease mood. Laughter is emotionally distracting. It can interrupt the blues or anxiety and cast everything in a new light.
• increase self-esteem. It’s easy as a caregiver to feel at the mercy of many forces and to feel like you can’t do enough. Laughter helps counteract feelings of low self-worth.

Want more laughter in your life?

• Read children’s books. They are often silly (Amelia Bedelia, anyone?). Ask a librarian for recommendations. The illustrations alone may bring a chuckle.
• Look for humorous gift cards at the store. Maybe even buy one to put on your refrigerator. In a couple of weeks, send it to a friend, and give yourself a new one!
• Play with a pet. If you don’t have a pet, find out if there’s a dog park nearby and go watch. Dogs are naturally joyful.
• Spend time with funny people. Some people have a knack for finding the humor in things. Laughter is contagious. You may even learn to laugh more at yourself!
• Choose comedy. When you’re selecting a movie to watch or a screensaver for your computer, look for something funny. Consider humorous podcasts. Visit joke websites or buy a joke book to add some humor to your conversations with others.
• Make silly happen at home. Dress your toast with raisin eyes and jelly mouth. Wear goofy socks. Play a game with friends.

Or just plain start laughing. Whether you’re laughing at someone’s joke or laughing for no reason at all, your body responds the same. Some people enjoy going to “laughter yoga” sessions where the point is to laugh in a group. It’s contagious!

Laughter is good medicine. And it’s free!

Are things getting too serious at your house?
Consider injecting more humor in your life. As the San Francisco experts in family caregiving, we at Compassionate Community Care know how big the stakes are when caring for an ailing family member. Still, laughter can ease the stress and doesn’t take away from your vigilance. It’s just one more tool in your toolkit to help you avoid burnout and continue the important work you do for as long as you are needed to do it. You don’t have to do this alone. Give us a call at (415) 921-5038.

When your loved one is hospitalized, getting word of discharge “soon” can be heartening: Yay! Improvement! And it also can be distressing. Many aspects of care may drop into your hands. Mobility, incontinence, wound care, oxygen…. And you may not have the needed help lined up.

Good news: There are options. Tell the doctor and the hospital discharge planner immediately of your concerns. According to Medicare regulations, they are required to work with whoever is the “family caregiver” to come up with a safe and appropriate plan.

The hospital may pressure you. (They get paid a fixed fee, so the earlier the discharge, the more money they make.) Your relative may pressure you, too. Ask the hospital for the reasoning behind the discharge plan. Stand your ground for a wise decision about timing and aftercare. If this seems daunting, consider the advocacy services of a Care Manager.

There is also a formal appeal process for discharge decisions, but timing is crucial.

• Upon admission, your relative should receive an “Important Message from Medicare.” Keep this paper. It lists the agency that handles discharge appeals. If you don’t receive this document, ask for it.
• Also upon admission, ask the case manager (aka, discharge planner) how long your relative will likely be staying and if they are officially “an inpatient” or just there for “observation.” The appeal process is only for patients who have been formally admitted.
• As soon as you have safety concerns about the discharge, alert the doctor and discharge planner.
• If the hospital persists with its discharge timetable, contact the reviewing agency immediately and ask for a “fast appeal.” You can ask for a fast appeal up to the day of discharge.

A review usually takes twenty-four to forty-eight hours. Medicare will continue to pay for your loved one’s hospital stay during the review (although the deductible and usual copays still apply).

Worried about potential after-hospital duties?
Give us a call at (415) 921-5038. As the San Francisco experts in family caregiving, we at Compassionate Community Care can help guide you through the process to figure out the best timing and combination of support services. You don’t have to do this alone.

Chronic inflammation occurs when the immune system doesn’t shut down properly. Instead, it attacks the body. This can last for months, even years. It’s like a persistent internal war. It puts the body under tremendous stress. There is growing evidence that chronic inflammation is involved with a number of problems common in aging. These include heart disease, some cancers, Alzheimer’s, and Parkinson’s. Also, bowel disorders, lung disorders, diabetes, depression, and several autoimmune conditions.

Most people don’t feel the symptoms of chronic inflammation directly. Instead, they discover it’s there when they delve into other health concerns, such as possible arthritis or unexplained weight gain or loss. Addressing chronic inflammation can ease the stress on the body and help slow the development of serious conditions.

Signs and symptoms. Because chronic inflammation can affect many body systems, you might want to talk with the doctor if your loved one is experiencing any of the following. (Yes, it’s a dauntingly broad list! But any combination of symptoms will help the doctor determine next steps):

• Joint or muscle pain and stiffness
• Fatigue and muscle weakness
• Gastrointestinal issues (diarrhea or constipation)
• Unexplained weight gain or loss
• Persistent infections
• Skin rashes
• Dry or gritty eyes
• Balance issues, especially when walking
• Insulin resistance (also known as “prediabetes” or “metabolic sy­­ndrome”)
• Depression, anxiety, or other mood disorders
• Brain fog

Getting tested. There is no one test for chronic inflammation. But there are a few blood tests that can indicate the level of generalized inflammation. C-reactive protein, sedimentation rate, and fibrinogen are the most common. Talk with the doctor. They may want to also order other tests to zero in on the particular system that appears to be under attack.

Are you concerned about chronic inflammation?
If the person you care for has any of these symptoms—and especially any of the associated conditions—talk with the doctor. As the San Francisco experts in family caregiving, we at Compassionate Community Care encourage you to be proactive. The earlier inflammation is tamed, the better for your loved one’s health. If you need a patient advocate, we can help. You don’t have to do this alone! Give us a call at (415) 921-5038.

When we are sad, often the best medicine is to talk with someone. If you are the person listening, you may find it challenging to witness your loved one’s sadness as they struggle with the losses inherent to illness and aging.

It’s natural to want to “fix” their emotional pain and make it go away. A common reflex is to suggest they “look on the bright side,” or reassure them that “everything will be okay.” Or jump in and help them by problem solving. While these responses may have their place, research shows that when done prematurely, such “helpful” strategies often backfire. The person you care for may simply feel invalidated and close down.

Instead, try these strategies for helpful listening:

• Provide nonverbal reassurance. Holding someone’s hand expresses support without words. Learn to allow for crying and even silence. If you start to feel anxious, calm your body with slow, deep breaths. Gently think about how much you care for this person.
• Encourage them to talk. Let them know they have your full attention. “I’m here to listen. I’m in no rush. Tell me what’s going on.”  Or, “Tell me more about that.” As the conversation ends, conclude with something affirming, such as “I’m so glad you shared this with me. It really helps me understand.”
• Practice active listening. Repeat or paraphrase what they have shared. “So, it sounds like you’re afraid this is going to be the end of your independence,” or “From what you’ve said, it sounds like you’re worried this might be a more serious diagnosis.” This helps them feel genuinely “heard.”
• Validate their feelings. Affirming phrases help people feel that they are not alone. It builds trust and a sense of connection. “I’d feel that way too,” or “I understand how you would respond that way.” While you want them to know they are not alone, resist the impulse to tell them of a time when you were sad, as that typically shuts people down.
• Wait for their cue before problem solving. It’s tempting to start “fixing things” as that is the eventual road to resolution. Instead, wait until you hear your loved one saying things like “I hate feeling this way,” or “I wish I knew what to do.” These are signs that they are ready to begin looking for solutions. Rather than giving advice, ask them questions that help them find their own solutions. “Where might you start? What might be a good first step?” If you have a solution you really want to propose, ask if it would be okay for you to share an idea.

Worried about a loved one who is sad?
Give us a call at (415) 921-5038. As the San Francisco experts in family caregiving, we at Compassionate Community Care understand how painful it is to watch a loved one grapple with sadness. And if you think they are depressed, it’s wise to get a professional perspective. You don’t have to do this alone.

Is mom considering an herb-based remedy? If so, she joins 24% of American adults who report using herbal medicines, supplements, or teas. Fifteen percent turn to chiropractors, while 9% use acupuncture and 6% use homeopathy.

You probably have heard individual success stories. But the risks and benefits of many alternative treatments have not been scientifically confirmed. And sometimes seemingly harmless herbs or supplements can actually interfere with prescription drugs.

It’s not that your loved one shouldn’t try alternatives. You simply want to take reasonable precautions and coordinate with your relative’s regular doctor.

Find a competent practitioner.

• Ask your relative’s doctor for a referral.
• Look online for a professional organization. They can provide information about training and licensing and a directory of providers.
• Find out if there is a state regulatory agency that records problem practitioners. Look up the license of any providers you are considering to be sure they are still licensed and no serious complaints have been made against them.

Learn about the practitioner. Check out their website or brochure. Ideally, have a brief, introductory interview in person or over the phone.

• Ask about training and licensing and years in practice.
• Find out about areas of specialization. Describe your loved one’s diagnoses. What can the provider tell you about the process and success rates for these conditions? Are there any research papers available? 
• Ask what your relative should expect in terms of benefits. What about risks? How might this treatment affect other current treatments?
• Inquire about office practices. What are the fees? The typical number of sessions? Do they accept Medicare? Is the treatment covered by your relative’s supplemental insurance?
• Will the complementary practitioner coordinate with the primary care physician?

Before starting treatment. Share the complementary provider’s plan with your relative’s primary care doctor. Does the doctor have any concerns? It’s better for your loved one overall if the two plans of care can become an integrated approach.

Is your relative interested in alternative healing?
Perhaps they have more faith in complementary medicine. Or maybe western medicine has not yet found a cure that matches your loved one’s standards for quality of life (for example, too many side effects). We at Compassionate Community Care understand the many reasons your family member might seek an alternative. Let us help you find credible practitioners. Give us a call at (415) 921-5038.

Imagine your mom has fallen for the third time this year. To you, it’s obvious she needs more support, perhaps home care. Your sister thinks mom should come live with her in another state. Mom’s finances are slim and she doesn’t want to leave her home. Consider these tips from seasoned negotiators:

Prepare ahead for a discussion

• What do you fear the most? Be honest: Losing mom’s approval? Your sister “winning” (again!)? Awareness of your fears will help you monitor your sensitivities and reactions.
• What do you believe they fear the most? Your sister may fear losing her status as the “insightful one.” Your mother may fear losing her beloved neighborhood.
• Come to the meeting calm and centered. Have a strategy, such as deep breathing, to help you remain grounded.

During the meeting

• Remember to smile. It also shows up in your voice.
• Listen more. Talk less. People reveal more or offer more during an uncomfortable silence.
• What is valid about their point of view? Cultivate nonjudgmental curiosity. New insights may emerge. Is your sister’s nursing background helpful? Does mom care more about independence than safety?
• Take your ego out of the equation. Remove any relationship baggage. It’s not the person, just the issues.
• If you find everyone digging in, rise higher. Getting above the weeds may enable you to see new options. Ask yourself:
  • How can I address their fears?
  • What are our shared goals, beyond the details of the “solution”?
  • Is there a way to simplify? The simplest solution is often the best solution.
  • What might a win look like for all of us?
  • How can I be generous? Small gestures can engender trust and get a conversation moving again.
• Consider an objective third-party facilitator. A Care Manager can lead a family meeting. You can also hire an eldercare mediator.

Is your family in gridlock about a decision?
As the San Francisco experts in family caregiving, we at Compassionate Community Care often see well-meaning individuals lock horns over difficult eldercare decisions. We can help! Often a knowledgeable “outsider” can guide a discussion toward a positive resolution. Give us a call at (415) 921-5038.

Does the person you care for tend to forget things, such as appointments? Do they get easily confused? Are they withdrawing from social situations? These changes may be early signs of Alzheimer’s or some other dementia. But it’s equally possible that the problem is hearing loss.

That is, it may not be a matter of their forgetting. They may not have heard what was going on to begin with, or misheard so they misunderstood. When in a crowded room with competing conversations, they may have trouble following the thread of the discussion. Many people with hearing loss amiably agree to things or simply nod because they don’t want to call attention to the fact that they really aren’t hearing very well.

Rather than make assumptions about your loved one’s cognitive abilities, ask the doctor to conduct a hearing test. If your relative does have hearing loss, wearing hearing aids can be a tremendous help. And, oddly enough, wearing hearing aids also significantly decreases the risk of dementia and/or slows down its progression.

Scientists are not quite sure why untreated hearing loss and dementia seem to go together, but hearing loss has been firmly established as one of twelve key risk factors. Those with untreated, mild hearing loss are twice as likely to develop dementia. The likelihood triples for those with moderate loss and is five times more likely with severe hearing impairment. Possible reasons include the following:

• Lack of auditory stimulation causes parts of the brain that process sound and memory to atrophy or shrink.
• People with hearing loss tend to withdraw from social situations. Lack of social contact is associated with greater risk of dementia and also depression. Depression can cause mental fuzziness and confusion, looking a lot like dementia.
• When a brain is struggling to capture sounds, it “borrows” brain capacity from other regions, which then limits how well those regions of the brain can do their usual work.

Hearing aids can help. Among people at high risk for dementia—people with high blood pressure or diabetes, for instance—those who wore hearing aids were 50% less likely to develop cognitive decline. Hearing aids are not an immediate fix, like “glasses for ears.” They do take getting used to. But recognizing that hearing aids can not only improve hearing and social relationships, but also reduce the risk of dementia, may motivate your loved one to wear them.

Are you worried about your relative’s memory and thinking abilities?
As the San Francisco experts in family caregiving, we at Compassionate Community Care understand how frightening the prospect of Alzheimer’s or some other dementia can be. Let us help you get answers about prevention and correct diagnoses. It could be as simple as hearing loss. You don’t have to do this alone. Give us a call at (415) 921-5038.

The multilayered “phantom hacker” or “tech support” scam is by far the most lucrative scam to date—$542 million was transferred to fraudsters between January and June 2023. Two-thirds of those victimized were persons over age sixty-five! Here is the typical scenario:

1. Tech support. A call, email, or text is received “from tech support” at a company such as Microsoft, telling the victim their computer has been hacked. The scammer requests the victim download special computer-sharing software “to allow a virus scan.” In fact, this allows the hackers to see the victim’s financial information.
2. Financial institution. Scammer No. 2 contacts the victim “from” their bank or brokerage firm, falsely confirming they have been hacked. The victim is told to transfer funds to a “protected third-party account.”
3. Government agency. Scammer No. 3, “from” the IRS, Federal Reserve, or other agency, contacts the victim saying their money can be protected by transferring it to special foreign accounts set up for this very purpose. Methods include wire transfer, cash, or cryptocurrency. Sometimes a letter is sent by mail on official-looking letterhead. Sadly, this step drains the victim’s accounts.

Tips to share with your family member

• Do not respond to calls, emails, or texts advising “you’ve been hacked.” Do not take any steps suggested.
• If you receive a message alerting you to problems, do not use any phone number or link that’s provided. Use another device to get the phone number of the company in question, and call directly.
• Never let a person unknown to you download computer-sharing software.
• Credible institutions do not ask you to transfer money by cash, gift card, or cryptocurrency.

If your loved one is at all suspicious, they should hang up immediately and contact you. You can contact the FBI at www.ic3.gov to investigate whether this is a fraud call or not.

Are you concerned about your relative’s vulnerability?
Older adults are not the only ones to get taken in by this scam. But they are the ones losing the most money! As the San Francisco experts in family caregiving, we at Compassionate Community Care understand your concern. We are happy to educate our clients about ways to reduce the chances of fraud. Give us a call at (415) 921-5038.

If your loved one gets admitted into the hospital, they may be disappointed that their primary care doctor is not the physician taking care of them. Instead, their care will be coordinated by a “hospitalist.” This is a doctor who specializes in caring for patients during a hospitalization.

Like most specialists, hospitalists have had many years of schooling (up to nine or ten). They have a medical degree and have completed a residency. They may even have gone on to a fellowship afterwards. The main difference is that they do not practice in an office in the community. They work only in the hospital.

Hospitalists are experts in handling acute illness. Unlike a primary care physician, hospitalists are part of the hospital’s staff. They can help your loved one recover faster and return home sooner because of their

• 24-hour availability. Hospitalists can respond quickly to changes in your relative’s condition
• knowledge of the hospital’s systems and procedures
• more-frequent contact with family members during the course of the day
• coordination of care with other professionals

Of course, the hospitalist won’t know your loved one’s personality or preferences. And they may not have access to your loved one’s detailed medical history. But the hospitalist’s job includes connecting with your relative’s regular doctors. And with electronic medical records, the hospitalist may be able to access the community doctors’ treatment notes.

You can help provide continuity by following these steps:

• Discuss medications. Bring the drugs from home. Or provide a complete list of everything your relative takes. Don’t forget vitamins and over-the-counter drugs. And let the hospitalist know of any drug allergies or adverse reactions in the past.
• Exchange contact information. Ask to meet the hospitalist. (There may be more than one assigned to your relative. Hospitalists work in shifts. But they are very sophisticated in their ability to transfer information to each other.) Explain that you will be handling your loved one’s care following discharge. Request to be contacted with updates during the stay. Also give the hospitalist the names and contact information of the community doctors regularly involved in your relative’s care.
• Contact community doctors. Call your relative’s regular doctors (primary care physician and any pertinent specialists). Let them know your loved one is in the hospital. Give them the hospitalist’s contact information. Most important, make an appointment to see the primary care doctor a week or two after your loved one is discharged.

Do you find yourself going to the hospital a lot?
The aging process often involves hospitalizations. As the San Francisco experts in family caregiving, we at Compassionate Community Care can help your loved one avoid hospitalizations as much as possible. And when they are needed, we can help you and your relative understand what’s going on and make decisions about treatment and discharge plans. Give us a call at (415) 921-5038.

Many aspects of aging involve sadness and loss: Loss of independence, a serious diagnosis, death of a partner, spouse, or friend. You as a family member may experience sadness as you witness your loved one’s struggles. But also, for your own caregiving-related losses, such as of leisure time with friends and family or opportunities at work.

Sadness is an important emotion and one that we all feel. It’s our natural response to loss or defeat. According to noted researcher Brené Brown, the fact that we all feel it is in some ways its strength. When we feel sad, we are moved. (It’s why we like sad movies.) We can relate to the sadness of others. It helps us feel connected—to feel our common humanity.

When we are sad, we feel better when someone reaches out to us. The acknowledgment is helpful. They too have felt sadness in their lives.

Sadness helps us become more compassionate, more empathetic. It can also prompt us to reevaluate our life and priorities and perhaps ask for help from others.

Sadness is different from depression. Sadness may be a part of depression, but in its intense form—for instance, tearful crying—sadness comes and goes. Depression lasts for an extended time (two weeks or more). Rather than tears, depression commonly shows up as a loss of interest in previously enjoyable activities. Also, problems concentrating and staying engaged. Depression includes physical symptoms such as lack of energy, sleep problems (insomnia or sleeping too much), or eating irregularities (a lack of appetite or overeating). Sadness is not something one treats. Depression is generally treatable.

Older adults have a high incidence of depression. So do family caregivers. If you recognize signs of depression in yourself or in the person you care for, reach out. Talk to a doctor or therapist.  

Are you worried about your loved one?
Or yourself? Do you recognize the signs of depression? As the San Francisco experts in family caregiving, we at Compassionate Community Care understand how hard it can be to care for a relative who has diminishing capabilities. You don’t have to do this alone. Give us a call at (415) 921-5038.