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.

Where do you go? Your relative has distressing symptoms. The primary care doctor’s office is closed, or they don’t have an opening anytime soon. The Emergency Room is open 24/7 but will involve long waits and a lot of stress.

An urgent care center is a great middle ground. It’s generally convenient—open evening hours—and is less crowded than the ER. Your relative will be seen fairly quickly. Consider urgent care if the situation deserves prompt attention (within 24 hours) but is not life threatening.

Appropriate conditions for urgent care include the following: 

• Aches and pains from a muscle sprain
• Sore throat, sinus pain, urinary tract or other infection
• Skin wound or swelling, such as from a skin tear or insect bite
• Diarrhea or other digestive upset
• Broken finger or toe

Treatment may be provided by a nurse practitioner or physician assistant. Some centers also have doctors on staff. Most urgent care centers can conduct basic blood work and other common diagnostic tests.

Go to the ER if your loved one has a more-severe condition.
This is the choice when time is of the essence, when your relative needs immediate attention by a doctor. (If the person you care for has a complex medical history, you might elect to go to the ER even if the situation is not dire. The ER is staffed by doctors who have easy access to specialists. They can determine if symptoms are related to your relative’s other conditions.)

Situations that call for the Emergency Room include the following:

• Chest pain or pressure
• Trouble breathing
• Compound bone fracture (bone has broken through the skin)
• Head injury
• Seizures
• Sudden paralysis or weakness on one side of the body (stroke)
• Severe pain anywhere (head, abdomen)
• Uncontrolled bleeding

Make plans ahead of a crisis.

• What are the centers closest to your loved one’s house?
• Which one does their primary care doctor recommend?
• What are the hours?
• Is a doctor always on site?
• Is the center on your family member’s insurance plan? If your loved one has Medicare Advantage, for instance, you may be restricted to centers within the network.

Ask for a treatment statement before you leave.
This is equally true for the ER or urgent care. As soon as possible, contact your loved one’s primary care doctor. Let the doctor know what treatment was provided and schedule a follow-up office visit, if advised.

Are you prepared for emergencies?
As the San Francisco experts in family caregiving, we at Compassionate Community Care understand that it’s hard enough to support a relative getting through the normal demands of daily life, let alone spend time getting prepared for emergencies. You don’t have to do this alone! Give us a call at (415) 921-5038. We can help.

Transportation problems create unhealthy social isolation for many older adults. Rides from family and friends are the first thought, but they aren’t always available, limiting your loved one’s opportunities. And older adults often feel uncomfortable being beholden to others for their transportation—and, ironically—for their “independence.”

Ride services offer an alternative in many parts of the country. But what to do if your loved one is not tech savvy? Innovators at both Uber and Lyft are pioneering app-free, phone-based, senior-friendly programs. All three services enable your loved one to speak to a live operator at some point to get a cost estimate for the ride and information for identifying the driver. Ask if help getting in and out of the car is available. Ride hailing is not appropriate if the person you care for has dementia. It’s not safe for your relative and is beyond a driver’s ability to support.

Does your relative have transportation challenges?
As the San Francisco experts in family caregiving, we at Compassionate Community Care notice that families spend a lot of time ferrying their loved ones from one place to another. Ride hailing is just one way to ease your load and give the person you care for a greater sense of independence. Give us a call to learn more: (415) 921-5038.

About 10% to 20% of cognitive impairments are a result of vascular dementia, also called “stroke dementia.”

Vascular dementia arises when the blood supply to the brain is interrupted by a blood clot or from bleeding in the brain (for instance, after hitting one’s head during a fall). Vascular dementia can come on suddenly, from a stroke. Or gradually over time (from “TIAs” or “ministrokes”).

A stroke doesn’t always result in dementia. Think of it like a power outage in different neighborhoods of the brain. A stroke can affect movement, speech, vision, thought, and/or language, depending on where the “outage” occurred and how long it lasted.

Vascular dementia may include changes to memory, logical thinking, emotional stability (depression or sudden bouts of crying), and/or unusual behaviors. Because repeated strokes and ministrokes can happen any time, the decline of vascular dementia is less predictable than that of Alzheimer’s, and can be more unsettling.

Risks and prevention. People at high risk for vascular dementia are those with conditions that affect the cardiovascular system: High blood pressure, atrial fibrillation, high cholesterol, obesity, diabetes, smoking, and a sedentary lifestyle. Addressing these factors helps reduce the likelihood of vascular dementia starting or worsening.

A full medical evaluation will identify which parts of the brain are struggling. This may reveal steps to stop or slow further progression.

Catch a stroke early. If a stroke is caught within the first three hours, the chances of recovery are much improved. Think “F-A-S-T”: Face: Ask the person to smile. Does one side of the face droop? Arms: Ask the person to raise both arms. Does one arm drift downward? Speech: Ask the person to repeat a simple sentence. Is their speech slurred or difficult to understand? Time: Call 911 for an ambulance if you see any of these signs.

Is your relative at risk for a stroke?
As the San Francisco experts in family caregiving, we at Compassionate Community Care help many families dealing with vascular dementia and the aftereffects of a stroke. You don’t have to do this alone. Give us a call at (415) 921-5038.

Hearing loss affects 50% of people over age eighty-five, most commonly men.

Poor hearing diminishes quality of life. It may bring on frustration in daily interactions with others. It can even be at the root of withdrawal from social activities, depression, anxiety, paranoia, and memory issues.

Even so, many elders deny they have problems with hearing or don’t seem to want to deal with it. One common reason is stigma. They may feel that people with hearing loss are stereotyped as older, less capable, and dull. (Who wants to join that club?) Not admitting the problem helps maintain needed self-esteem.

If you suspect your family member has hearing loss:

• Learn if they think there is a problem. Explore gently. “You’ve gotten very quiet at family dinners. Has something changed?” See if your relative is disturbed about times they haven’t heard something and have been confused or frustrated afterwards.
• Is there something that is actively bothersome for them? If there’s something they like but feel thwarted in doing—hearing the conversation in a restaurant, understanding the audio in a movie—this could be a motivator for action.
• Learn what they know about solutions. If your loved one identifies problems with hearing, explore the topic of solutions. See what reasons are given for not taking action.
• Acknowledge their concerns. Don’t discount what might appear to be vanity. Instead, talk about how small hearing aides have gotten. Also about the drop in price with new over-the-counter versions.
• Identify others with hearing loss. Give examples of people your relative knows and respects who have addressed their hearing loss. Perhaps your family member would feel comfortable contacting them for tips and lessons learned.
• Recommend an exam by a doctor. Fixing the problem may not require hearing aids. Hearing loss could be from a buildup of earwax. Or a medication side effect. Seeing the doctor could be the first step to a solution.

Frustrated about your loved one’s resistance?
A full 20% to 25% of people who need hearing aids don’t want to use them. As the San Francisco experts in family caregiving, we at Compassionate Community Care can help you learn how to address the problem in a way that is most likely to plant the seed. Give us a call at (415) 921-5038. Let’s start the conversation.

If the person you care for needs therapy or other medical services but has trouble getting out, house calls are a great solution. Historically, Medicare has had strict rules for home-based services and how “homebound” a patient must be for the services to be covered. It also limits the number of visits per week or the number of weeks allowed for care at home. In addition, the rules typically require a certain level of improvement in the patient for services to continue. Some of these rules are loosening. It’s worth checking. If you find Medicare won’t cover a service, you may have the option to pay privately. A Care Manager can help you find a provider.

Physicians. If your relative is frail and you don’t want the drive or the wait in the doctor’s office, consider finding a primary doctor who has arranged with Medicare to make house calls. Check out the American Academy of Home Care Medicine.

Rehabilitation therapists. Hiring privately allows for more visits per week or for a longer time period if your loved one’s progress is slow. This can mean the difference between a full versus a partial recovery. Or even better quality of life, with your relative retaining as much functioning as possible even if they aren’t “improving.” 

• Physical therapists help with exercises to improve movement and relieve pain. 
• Occupational therapists identify exercises and “adaptive technology” to make it easier to perform daily tasks of living. 
• Speech pathologists suggest exercises and techniques for swallowing and speech problems. They also teach strategies to offset logical thinking problems due to dementia. 

Psychotherapists. Is your loved one reticent to seek counseling? Home visits can feel more like a friendly chat. Your relative may feel safer and more in control on their home turf. Plus, house calls also allow for more privacy if they have concerns about stigma—no one will see them walking into a counselor’s office. Ask the therapist whether Medicare will cover home visits. 

Check for quality. There are fewer guardrails on quality for home-based providers. Ask for references and always ask if they are licensed or board certified. Get their license number and look it up to see if there have been complaints or suits against them. If they can’t give you a license number, you might want to think twice. 

Are you looking for house call services?

As the San Francisco experts in family caregiving, we at Compassionate Community Care understand that sometimes it’s just too hard to bring your loved one to an office or clinic setting. Luckily, innovators are coming up with new options to provide these services at home. Let us help you with resources for your caregiving. Give us a call at (415) 921-5038. You don’t have to do this alone.

If you have dressed a relative with dementia or assisted a family member with Parkinson’s, you know there are challenges involved. Dressing requires physical coordination, fine-motor skills, flexible joints, and range of motion. Not being able to dress oneself is both frustrating and embarrassing. Fortunately, clothes designers have developed garments with important adaptations. 

Adaptive clothing typically incorporates these features:

• Easy closures. Look for snaps, hook-and-loop fasteners, Velcro, or magnets. (Avoid magnets if your loved one has a pacemaker.)
• Pull-over shirts or dresses that have no closures. With broader necklines and loose sleeves, there is no need to fuss with buttons or zippers. These garments do, however, require the ability to lift one’s arms above one’s head.
• Elastic waistbands. No zipper or belt. The easy on and off is especially helpful when incontinence is involved. Elastic is also forgiving of fluctuations in weight.
• Opening down the back or sides. These garments are particularly useful when incontinence and mobility are issues. They have a significant overlap of fabric at the openings. They give you greater access as the caregiver while preserving your family member’s modesty by keeping their front covered.

Other qualities to keep in mind

• Bright colors for greater visibility. If your relative has dementia and tends to wander off, bright colors make it easier to spot them. 
• Soft materials and flat or minimal seams for sensitive skin. Avoid wool or other scratchy fabrics if the person you care for has delicate skin. Also steer clear of polyester because this fabric can develop a static charge and give off a painful, unexpected spark.
• For bras, look for front-closure or pull-on styles.
• For shoes, look for slip-ons, extra wide sizes, and no laces. 

Help preserve your loved one’s dignity by getting them clothes that support their independence. Google “adaptive clothing” to find online vendors. 

Looking to boost self-esteem and independence?

As the San Francisco experts in family caregiving, we at Compassionate Community Care know how difficult it can be to help an aging relative get dressed. You don’t have to go through this frustration alone. We have resources and strategies to help. Give us a call at (415) 921-5038.