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.

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.