Does your loved one need to downsize? Move? Does the prospect seem overwhelming? Perhaps not just physically, but emotionally too? Enter the senior move manager: Part mover, part interior decorator, part compassionate friend. These professionals take a holistic approach. They handle the physical logistics. They are also skilled at assisting older adults with the emotional side of a move.

Senior move managers provide services from A to Z. You can buy a full package or hire them for tasks à la carte.

• Outlining a plan for the move
• Developing a comprehensive floor plan of the new place
• Reviewing and sorting possessions
• Selling/disbursing items that won’t be moved
• Interviewing, scheduling, overseeing movers
• Packing or supervising the mover’s packers
• Arranging shipments and storage
• Unpacking and setting up the new dwelling

Fortunately, move managers can help an older adult come up with creative solutions for shedding possessions while preserving the memories. (“How about we save three of your favorite trophies and put them on special display? We can photograph the others to rotate through on your screen saver.”) They know how to work with persons who have dementia. Some also understand hoarding.

Senior move managers can yield money savings too. They know where to get best prices for antiques, books, and other collectables. They often have relationships with allied professionals such as realtors or contractors who may even offer a discount for their services. And don’t forget that a senior move manager can spare you from taking time off work for packing and unpacking. Or that extra plane flight to get things organized.

If this all sounds good, look for a move manager who is a member of the National Association of Senior & Specialty Move Managers. Members have training and insurance and abide by a professional code of ethics.

Is a move in your future?

Consider the services of a senior move manager. As the San Francisco experts in family caregiving, we at Compassionate Community Care have seen move managers be especially helpful for working family members and long-distance caregivers, saving time off work and travel headaches. The greatest joy is the “big reveal,” when the move managers set up the new residence according to the floor plan created with your relative. When your loved one walks in, it feels like home already! This eases the transition tremendously. To learn more, give us a call at (415) 921-5038.

Frontotemporal dementia (FTD) is an umbrella term for a cluster of conditions that makes up about 10 percent of dementia cases. It’s the most common form when dementia occurs before age 65.

What sets FTD apart is a sudden and dramatic change. Often in a person’s behavior. But speech and/or movement abilities can be affected. Memory loss comes later. As a caregiver, you want to focus on managing symptoms. And on finding FTD specialists to make life easier for everyone.

Take note of these key strategies

• Behavioral symptoms. Apathy, resistance, or even combative responses. People with FTD often undergo a dramatic shift in personality. For example, social inhibitions may disappear. As a result, they may say or do rude things. Don’t take what they do personally. It’s the disease! Observe which situations or times of day tend to set your loved one off. Then work with an occupational therapist. They can help you create a daily routine that avoids triggers and reroutes the behavior.
• Speech problems. Your loved one may not be able to find words. Or understand the spoken word. This is frustrating for everyone! Work with a speech therapist. They can show you communication techniques that match your loved one’s abilities.
• Movement problems. From tremors to muscle weakness, your relative may be at high risk for falls. Work with a physical therapist who specializes in FTD. They can help your loved one stay safely mobile for as long as possible.

Get support for yourself. Especially if your loved one is your spouse and you are under 65. There are many midlife passages you may have to navigate by yourself—for both of you. Talk with a therapist who understands FTD. And find a support group by contacting the Association for Frontotemporal Degeneration: info@theaftd.org or 866-507-7222.

Are you dealing with FTD?
This is a challenging disease. As the San Francisco experts in family caregiving, we at Compassionate Community Care observe that it really takes a team when you’re grappling with the many disruptive symptoms of FTD. Let us help. Give us a call at (415) 921-5038.

The majority of us feel obliged to help an ailing parent (77 percent, according to Pew Research Center). But if your parent is okay and your stepparent is ill, then what? Should you help with caregiving? (Pew data indicate 56 percent of us feel obliged.) What if your parent also has health challenges and providing care is too much? What about your stepsiblings?

These are good questions best answered in advance.
Here are some ways to generate teamwork no matter who is involved.

• What are the elders’ thoughts about care? Talk with your parent first, but eventually with your stepparent also. Ask: When the time comes that more help is needed, what are their plans? Stay at home and hire helpers? Get help from the kids? (Any thoughts about who might do what?) Move to assisted living or memory care (together or apart)? Move in with family? (Whose?)
• Create connections. Perhaps you grew up together. Or it may be that you’ve never met your stepsiblings. (This is not unusual with a late-life marriage. But you don’t want your first meeting to be in the ER!) At the least, identify one or two of your stepparent’s children you think might be receptive and trade emails and phone numbers. Frame it as a way to keep each other apprised in case problems are observed with either parent. Consider “liking” them on Facebook and making supportive comments now and then. That’s an easy way to start building a friendly rapport that will be invaluable in a crisis.
• Offer to get a conversation started with all the siblings. Perhaps hold a meeting of the “family” with all its members. This way both parents can share their thinking so far. If even a virtual meeting is impractical, you might encourage the parents to write a joint letter to all the siblings so everyone gets the same information at once.
• If the parents aren’t sure what they want. Ask what you might do to help. Perhaps you can facilitate a meeting of just the siblings—no parents—to see who is available to do what should the time come that help is needed.
• Set aside family politics. Every family has baggage. Perhaps you already have some strong feelings about your stepsiblings. When dealing with aging parents, it’s necessary to leave issues with each other at the door and focus simply on helping the elders in need. If this proves unmanageable, consider hiring a professional such as a care manager or a counselor who is trained to facilitate family meetings.

Do you know your stepsiblings?
Modern families are complicated. As the San Francisco experts in family caregiving, we at Compassionate Community Care have seen all kinds of arrangements. If the children knew each other in their younger years, there can be more of a family feel (but also potentially bad feelings). If it was a late-life marriage, there may be less rivalry, but there can also be less cohesion. Let us help you create more of a caregiving team. Give us a call at (415) 921-5038.

Here’s a prescription for pain relief: the sound of music.

Pain is very real. It is also a perception. How strongly we feel pain at any given time depends a good deal on our thoughts and mood. Music has a profound influence on both. Indeed, research shows that using music as therapy can reduce the experience of pain.

For immediate relief of sudden pain, music therapists suggest music with a strong, positive rhythm or lyrics. Maybe tunes from a favorite musical or an upbeat instrumental composition. Such attention-getting music provides a good distraction and stimulates release of the body’s natural painkillers.

For relief from chronic pain, soothing music has proven to be the best. In this type of therapy, a chosen piece is played over and over again. While the music is playing, the listener practices relaxation techniques. After a period of such “conditioning,” just hearing the music cues a deep sense of ease.

You can help your loved one try music therapy at home.

• Find the right music. Have your relative listen to a variety of music. Rate each piece twice: for enjoyment and for relaxation. Identify the pieces that score highest in each area.
• Compile music sets. Create unique combinations or playlists: one for upbeat distraction and one for soothing.
• Prepare for sudden pain. Before and during any potentially painful procedure, listen to the attention-focusing music. (Headphones or earbuds are great for this!) The distraction may reduce your relative’s experience of pain. It can also make the time seem to go by more quickly.
• Condition against chronic pain. Over a period of weeks, have your family member listen repeatedly to calming music. At the same time, he or she practices rhythmic deep breathing and pleasant mental imagery. This links the music to deep relaxation.

Is the person you care for in pain?
As the San Francisco experts in family caregiving, we at Compassionate Community Care know how pain can color everything! Mood, relationships, appetite, stamina. If pain is dominating your family experience, give us a call at (415) 921-5038. Let’s start the conversation.

If you are caring for a parent or parents who abused or neglected you in childhood, your situation is especially challenging. You may feel on an emotional tightrope, trying to keep your balance, with many conflicting feelings. For example,

• guilt, that you “should” take care of your parent, no matter how he or she treated you
• resentment, that their illness forces you to maintain close contact
• hope of finally receiving your parent’s love and approval

Research indicates that you are put at much greater risk of depression by these stressors than are those who did not experience parental abuse or neglect. Protect yourself with a strong safety net:

• Counseling. Resolve old issues, especially if you never had an apology from your parent. Learn skills for coping with difficult emotions as they arise. Identify your current strengths and life goals.
• Personal limits. Clarify what you will and won’t tolerate so you can maintain healthy boundaries.
• Coping strategies. Guard against common, unhealthy stress outlets, such as overeating, drinking, smoking, taking sleeping pills, and using other drugs. Or even going numb to your life. Instead, engage in something that is dependably rewarding, such as exercise, a singing group, or a caregiver support group.
• Self-protection. Develop ways to help your parent that keep in-person contact to a level that is manageable for you. For example, an in-home care agency can perform daily care tasks. You can guide what is done, yet maintain a buffer between you and your parent(s). Or hire a care manager to oversee what’s needed, take your parent to the doctor, coordinate care, and make recommendations as health conditions change.
• An exit plan. It is wise to have a clear “Plan B” in case the close personal interactions of caregiving prove to be too much. For instance, a legal guardian can be appointed to take over in your stead. Talk to a care manager or an elderlaw attorney about the range of options.

Have relations always been rocky?
You don’t have to do this alone. As the San Francisco experts in family caregiving, we at Compassionate Community Care work with families all the time who just need to have a buffer. It’s very, very common. Give us a call at (415) 921-5038. Let’s start the conversation.

The bathroom is often the most challenging (and least safe) room in the house for someone who is visually impaired: Poor lighting, or lighting that’s too bright. Lots of white-on-white furnishings and shiny fixtures. Hard-to-read settings on faucets. Tiny caps and tamperproof closures on personal care products and medications. And many small items for specialized tasks. Consider the adaptations below as you strive to make your loved one’s home environment support their independence.

Color contrast. Linens such as towels and washcloths should be a strong color contrast with wall, tub, and counter surfaces. Install a nonskid, high-contrast bath mat so your relative knows where to stand and not slip. Wrap grab bars with colored tape so they stand out from other shiny surfaces. Teach your loved one to float a brightly colored sponge when filling the tub to more easily ascertain water height. A contrasting color for the toilet seat is also helpful.

Lighting. Experiment with different types of light in different situations. For instance, there are toilet lights that give off a soft glow inside the bowl for nighttime navigating. For detailed work, like shaving or putting on makeup, add a magnifying mirror on a flexible arm. Some include lighting.

Faucets. Set the hot water heater to medium-range temperature. Mark sink and shower faucets with a bright color or contrasting texture to show the position for comfortable hot water. Have your relative use an on/off, handheld shower nozzle to test shower water temperature before stepping in. In two-faucet situations, learn to turn on the cold water first, then add hot water. Similarly, turn off hot water first and then the cold.

Clutter. Purchase a shower caddy to keep shampoos, razors, and soaps all in one place. Place a rubber band around the shampoo bottle to distinguish it from the conditioner. Provide soap on a rope so the soap is less likely to slip away.

Is vision loss a concern?
As the San Francisco experts in family caregiving, we at Compassionate Community Care can help you find the professional advice you need for promoting independence despite visual impairment. Give us a call at (415) 921-5038.

The U.S. Surgeon General reports we have a loneliness epidemic.

Like smoking and obesity, social isolation creates a greater risk for poor health. It’s been associated with a 48 percent increase in “premature death” (a death where a change in lifestyle could have resulted in a longer life).

Our social health affects our physical health.

Isolation. How much contact is enough? Canada is working on “social health guidelines” that would serve much like the nutrition guidelines put out by the Food and Drug Administration in the United States. They recommend one to three hours of socializing per day. Even light exchanges with a salesperson or sharing a laugh at the dog park count. We are social beings! That said, it’s family and old friends that make us feel seen, understood, and loved.

What you can do. The motivation and action must come from your loved one. But there are things you can do to remove or reduce barriers.

• Transportation. What are the barriers to attending an event? Are there ways you can help? (Provide a ride. Facilitate a Lyft or Uber account.)
• Hearing loss. Hearing loss can make conversation a chore. Hearing aids will help. Consider also a phone for the hearing impaired that can boost volume as needed.
• Home environment. Is your loved one too embarrassed by untidiness to invite people in? Consider housecleaning help or setting up visits outdoors on a porch or patio.

Tips for socializing. We got out of the habit with the pandemic. Here are a few insights:

• It’s easier to revitalize an old friendship than start a new one. It takes time and repeated exposure to cultivate a new friend.
• Create a two-person book club. Suggest reading and discussing a book with a friend or acquaintance. Or pick a TV show or streaming series to watch and discuss. The repeated exposure builds rapport.
• Small gestures are powerful. We’re naturally drawn to people who seem to like, notice, or appreciate us. A “thinking of you” text or a congratulatory email can go a long way toward building or strengthening a friendship.
• To gain a friend, be a friend. Suggest they look for opportunities such as offering to pick up the newspaper when a neighbor is gone or becoming a morning check-in buddy for someone else who lives alone.

Are you worried about your loved one’s isolation?
As the San Francisco experts in family caregiving, we at Compassionate Community Care see this as a growing concern. Want to brainstorm about ideas? Give us a call at (415) 921-5038. Let’s start the conversation.

Once your loved one is in their new home, the two of you will have a lot of adjusting to do. Like any big change, it takes time to find a new internal balance, a “new normal.” One to three months is about average.

For you. Expect a range of emotions: Sadness, guilt, doubt, and anxiety. You may feel that you’ve failed. Understand that 90 percent of families are not able to provide the necessary 24/7 care. It’s the disease that’s to blame, not you. Acknowledge that their new environment provides fresh shifts of care providers around the clock. It also gives your relative access to activities and opportunities to socialize. There are good reasons you made this choice.

For your loved one. They too will have feelings arise and be confused. It may seem that their dementia is suddenly worse. (This is a natural response to disruptions in routine. Over time the initial anxiety and agitation will diminish, although the disease will also be progressing, as it would have at home.) Listen to their feelings and acknowledge them. “I know this is hard. I don’t like it either. It’s not something we expected!” Trying to talk them out of their feelings usually backfires. And reasoning is not their strong suit. Instead, have a story in place that the family and staff all repeat: “The doctor said you need to stay here for a while.” “The house isn’t safe right now.” Don’t say that this is their new permanent home. Just let them know they are safe and that you know where they are.

Other tips

• Follow staff guidance about frequency and length of visits.
• Ask the staff if your relative’s behavior is normal for the length of time they have been there.
• Participate in activities when you visit so when the activity concludes, it’s natural for the visit to end too.

Concerned about the adjustment?
As the San Francisco experts in family caregiving, we at Compassionate Community Care have helped many families through this journey. Give us a call at (415) 921-5038.

Whether it’s a bowl of soup or a bag of groceries, providing food is how we show our love. And when a relative has a serious illness, it’s natural to want them to eat a healthy diet.

Many chronic conditions respond well to specialized diets. Diabetes and heart disease, for instance, can be managed very well with diets low in sugars and fat. When an individual is robust and active, such nutrition supports healthy aging. You may have spent years, even decades, encouraging your loved one to reduce fat, forego salt, or avoid dessert.

With advanced illness or for a frail elder, there may be reason to rethink this approach. It may be time to put some of the gravy back on the table.

The American Dietetic Association points out that eating is more than a physical process. Food is

• social—an opportunity to join with others
• cultural—a ritual that honors history, identity, and place
• emotional—a trigger of fond memories, often bringing soothing effects

For the frail elderly, restrictive diets may not be all that helpful. Instead, dieticians advise an individualized approach that supports overall health and well-being. They recognize that

• enjoyment of life is key to a balanced approach to health
• bland foods can reduce appetite
• losing interest in food depresses quality of life
• not eating enough hastens frailty

If your loved one has an advanced illness or is becoming weaker, it may be that a less restrictive diet is in order. If you are concerned, ask the doctor. Perhaps a review by a dietician can be arranged.

Is quality of life a concern?

As the San Francisco experts in family caregiving, we at Compassionate Community Care notice that families can have the best intentions, but sometimes they are working on momentum, emphasizing treatments that may no longer be helpful since conditions have changed. Would you like assistance with making wise changes? Give us a call at (415) 921-5038. You don’t have to do this alone.

As a rule, family caregivers are generous. They tend to be empathetic and to want to help. But it is possible to be too generous, with a tendency to sacrifice one’s own needs for the benefit of others. Sound familiar? This is called “pathologic altruism.” People who feel compelled to give despite risks to themselves often end up depleted and depressed (and ironically, less able to give and be helpful).

Current research is exploring the idea that altruism is not all good. And similarly, selfishness is not all bad. In fact, there is such a thing as “healthy selfishness,” defined as “having a healthy respect for your own health, growth, happiness, joy, and freedom.” Sound good? See how you measure up on the Healthy Selfishness Scale:

• I have healthy boundaries.
• I have a lot of self-care.
• I have a healthy dose of self-respect and don’t let people take advantage of me.
• I balance my own needs with the needs of others.
• I advocate for my own needs.
• I have a healthy form of selfishness (e.g., meditation, eating healthy, exercising) that does not hurt others.
• Even though I give a lot to others, I know when to recharge.
• I give myself permission to enjoy myself, even if it doesn’t necessarily help others.
• I take good care of myself.
• I prioritize my own personal projects over the demands of others.

Contrary to what you might have been taught about selfishness, people who score high on this survey are not prideful or domineering. Instead, they tend to be very giving and retain a great desire to be helpful to others. So the next time you find yourself depleted, review the qualities named above. Consider how you might lean more in the direction of healthy selfishness to recharge and sustain your ability to help over the long haul.

Are you feeling drained or depleted?
As the San Francisco experts in family caregiving, we at Compassionate Community Care see family members sacrifice so much for their loved ones. Unfortunately, this can backfire in the form of burnout and ultimately, worse care for their relatives. Let us help before you get to that point. Give us a call at (415) 921-5038.