Carol Bradley Bursack, CDSGF
Author, speaker, columnist and eldercare consultant
Over the span of two decades, author, columnist, consultant and speaker Carol Bradley Bursack cared for a neighbor and six elderly family members. Her experiences inspired her to pen "Minding Our Elders: Caregivers Share Their Personal Stories," a portable support group book for caregivers.
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Question
Is it wrong to just want it to end?
Hi Robert, Palliative care is comfort care for those going through treatments. You may be interested in this article:... Hi Robert, Palliative care is comfort care for those going through treatments. You may be interested in this article:
https://www.agingcare.com/articles/Palliative-Care-What-Is-It-and-How-Is-It-Different-from-Hospice-197744.htm
It's a great program!
Carol see more
https://www.agingcare.com/articles/Palliative-Care-What-Is-It-and-How-Is-It-Different-from-Hospice-197744.htm
It's a great program!
Carol see more
Question
Is it wrong to just want it to end?
Please check with your doctor, Robert. This is definitely a medical emergency. If you need someone to help, a clergy member or counselor... Please check with your doctor, Robert. This is definitely a medical emergency. If you need someone to help, a clergy member or counselor might be a good call.
We are thinking of you,
Carol see more
We are thinking of you,
Carol see more
Question
What do I do if I suspect my mom is in the beginning stages of dementia?
Try writing the doctor a letter detailing her behavior. It sounds as if you do not have a Durable Power Of Attorney for medical issues.... Try writing the doctor a letter detailing her behavior. It sounds as if you do not have a Durable Power Of Attorney for medical issues. Does anyone in your family have that document for your mother? If so, have that person contact the doctor. If not, you are going to have issues getting the information
Either way, the doctor clearly sees problems and would likely welcome your input. What he or she can do about it without help from the family is hard to tell. Try this step anyway and see what happens.
I agree that the head injury could have contributed to this - maybe sped up the development that had already begun.
Good luck,
Carol see more
Either way, the doctor clearly sees problems and would likely welcome your input. What he or she can do about it without help from the family is hard to tell. Try this step anyway and see what happens.
I agree that the head injury could have contributed to this - maybe sped up the development that had already begun.
Good luck,
Carol see more
Question
Medicaid denied my mother because of a life insurance policy that has accumulated some money?
Whoever you talked with about Medicaid should have asked you, when you signed up, if there were any policies that had cash value and told... Whoever you talked with about Medicaid should have asked you, when you signed up, if there were any policies that had cash value and told you that upfront what to do. They are the ones that are responsible for this.
Anyway, it's true that the cash value belongs to Medicaid. That money is counted as assets. I'm sure that there are ways to plan around this with an attorney but I think that it is too late to do it now.
Take care,
Carol see more
Anyway, it's true that the cash value belongs to Medicaid. That money is counted as assets. I'm sure that there are ways to plan around this with an attorney but I think that it is too late to do it now.
Take care,
Carol see more
Question
Cannot get physician to sign Medicaid and my Family Leave papers. What can I do?
Your frustration must be at peak level - most of would be ready to tear our hair out. I feel so sorry for you! Sadly, you may have to do as... Your frustration must be at peak level - most of would be ready to tear our hair out. I feel so sorry for you! Sadly, you may have to do as was suggested and make an appointment. Bring in a new set of papers and wait while they get signed. This is something that likely gets put at the bottom of the pile day after day.
Good luck,
Carol see more
Good luck,
Carol see more
Question
My mom was picking at her butt and now has an open wound. Could it be a bedsore?
I'd keep the meeting as friendly as possible but make it clear that you are wondering about bed sores (which could be a possibility for... I'd keep the meeting as friendly as possible but make it clear that you are wondering about bed sores (which could be a possibility for sure). The idea of not using protective cream, as Bonniepages mentioned also makes sense. Certainly a wound doctor is a good call so I give the NH credit for that. Some would ignore it. Make it plain you expect that this won't happen again.
Good luck to you and your mom,
Carol see more
Good luck to you and your mom,
Carol see more
Question
What do I do when the person taking care of my mom no longer wants to?
tcrash21, you've been amazing. Your aunt has stepped in, too, which makes her pretty special, but likely she's not young and... tcrash21, you've been amazing. Your aunt has stepped in, too, which makes her pretty special, but likely she's not young and can't do it forever.
I agree with the other posters that we'd need more information about why your mom needs help. However, eventually, she will. As Jeannegibbs suggested, have social services come out and do an evaluation. Be up front about your own situation since the stress of caring for your mom could set you back to where you can barely care for yourself. I believe that your whole family needs to be on record as needing services.
Please check back with us when you can. I'm worried about how you are doing with so much stress.
Carol see more
I agree with the other posters that we'd need more information about why your mom needs help. However, eventually, she will. As Jeannegibbs suggested, have social services come out and do an evaluation. Be up front about your own situation since the stress of caring for your mom could set you back to where you can barely care for yourself. I believe that your whole family needs to be on record as needing services.
Please check back with us when you can. I'm worried about how you are doing with so much stress.
Carol see more
Question
Is there a waiting period from the time a life insurance policy is taken over by a child until the parent can...
In most cases, the cash is considered part of the 5 year look back. If there is an irrevocable trust set up, you'd have to check on... In most cases, the cash is considered part of the 5 year look back. If there is an irrevocable trust set up, you'd have to check on that with whoever set up the trust or with Medicaid.
Each state has its own rules, so to be very certain contact an attorney who knows your Medicaid laws well. In my own opinion, it's best to be cautious. Your kids don't want any nasty surprises down the road. As a rule, consider the five year look back unless you have other options.
Carol see more
Each state has its own rules, so to be very certain contact an attorney who knows your Medicaid laws well. In my own opinion, it's best to be cautious. Your kids don't want any nasty surprises down the road. As a rule, consider the five year look back unless you have other options.
Carol see more
Question
Anyone think it's a great idea to give Ambien to Alzheimer's patients with GERD?
There are many good suggestions here. I'd suggest treating the GERD as a separate issue. Ambien has many possible side effects even for... There are many good suggestions here. I'd suggest treating the GERD as a separate issue. Ambien has many possible side effects even for healthy people. The idea that it would be good for someone with Alzheimer's should be discussed with a doctor who understands Alzheimer's well. It doesn't sound like a good idea to me, as a layman, however.
There are some age old calming remedies that help people relax (such as chamomile) that could be tried, but even then you might want to confer with the doctor.
Sadly, getting up many times a night is common with AD even without complicating factors such as GERD.
Take care,
Carol see more
There are some age old calming remedies that help people relax (such as chamomile) that could be tried, but even then you might want to confer with the doctor.
Sadly, getting up many times a night is common with AD even without complicating factors such as GERD.
Take care,
Carol see more
Question
Is it dementia if my mother is only mean to me?
I’m so sorry that you’re going through this petsilove ! I agree that often it's the person who is providing the most care who is... I’m so sorry that you’re going through this petsilove ! I agree that often it's the person who is providing the most care who is singled out for criticism. The person being cared for resents the loss of independence and would lash out at anyone. Sometimes we caregivers really are taking over their lives and their resentment is understandable. At times, caregivers could do things better, but at other times there seems to be no other way to handle these difficult changes.
One note about the daughter believing the grandmother: I've seen this happen when others don't know the degree of mental deterioration. They listen to someone like the grandmother complain and believe her because she sounds so clear and mentally sound. In this case, the daughter doesn't seem to understand that this is the disease talking. It's heartbreaking but not unusual.
There are times when family members aren't the best full time caregivers. Either because of family dynamics or because of dementia, the person with the disease is better off in the case of others through no fault of their caregiver. Remember, too, that not all dementia is Alzheimer's and some types of dementia bring about big personality changes, paranoia and even hatred of a single person in the family. If this happens, it helps no one to continue trying to be the primary caregiver.
The fact that you and your mother didn’t get alone before makes all of this harder. Likely, subconsciously, you want to show her that you are a wonderful daughter. She, on the other hand, is just getting worse. Don’t blame yourself. You’re in an impossible situation (if you want some peace). Try to get her care from other sources.
Take care,
Carol see more
One note about the daughter believing the grandmother: I've seen this happen when others don't know the degree of mental deterioration. They listen to someone like the grandmother complain and believe her because she sounds so clear and mentally sound. In this case, the daughter doesn't seem to understand that this is the disease talking. It's heartbreaking but not unusual.
There are times when family members aren't the best full time caregivers. Either because of family dynamics or because of dementia, the person with the disease is better off in the case of others through no fault of their caregiver. Remember, too, that not all dementia is Alzheimer's and some types of dementia bring about big personality changes, paranoia and even hatred of a single person in the family. If this happens, it helps no one to continue trying to be the primary caregiver.
The fact that you and your mother didn’t get alone before makes all of this harder. Likely, subconsciously, you want to show her that you are a wonderful daughter. She, on the other hand, is just getting worse. Don’t blame yourself. You’re in an impossible situation (if you want some peace). Try to get her care from other sources.
Take care,
Carol see more
Question
I am burned out. What do I do?
Notwonderwoman, your name on the site says it all. None of us are wonder woman, believe me! Many of us have had very low times with much... Notwonderwoman, your name on the site says it all. None of us are wonder woman, believe me! Many of us have had very low times with much less to handle than you have.
You should not have to be so anchored to your home and your husband's care that you can't do anything for yourself. It’s not sustainable. If you had someone come in everyday for a few hours so that you could go out, that would be wonderful, but it's not likely to happen.
Suggesting a nursing home may seem extreme but if your health breaks down - mental and/or physical - that's what would happen anyway. And then your husband would lose your companionship.
As hard as it is to think about, it seems as if you should try for assisted living (if your husband qualifies physically) or nursing home care for him. To paraphrase sandwich42plus, if you aren't doing all of the physical and emotional work, you can spend a lot of time with your husband with a refreshed body and mind. You are not giving up on him by placing him in care. You are preserving your future together in the best manner that you can.
Burnout can turn into compassion fatigue which is truly an awful place to be. Please consider looking into this move – without guilt! You’ve spent 3 years glued to your husband’s side caring for him and you are breaking down. Anyone would.
You may find this article helpful: https://www.agingcare.com/articles/compassion-fatigue-caring-too-much-196224.htm
Take care of yourself, my friend. By doing so you are taking care of your husband. see more
You should not have to be so anchored to your home and your husband's care that you can't do anything for yourself. It’s not sustainable. If you had someone come in everyday for a few hours so that you could go out, that would be wonderful, but it's not likely to happen.
Suggesting a nursing home may seem extreme but if your health breaks down - mental and/or physical - that's what would happen anyway. And then your husband would lose your companionship.
As hard as it is to think about, it seems as if you should try for assisted living (if your husband qualifies physically) or nursing home care for him. To paraphrase sandwich42plus, if you aren't doing all of the physical and emotional work, you can spend a lot of time with your husband with a refreshed body and mind. You are not giving up on him by placing him in care. You are preserving your future together in the best manner that you can.
Burnout can turn into compassion fatigue which is truly an awful place to be. Please consider looking into this move – without guilt! You’ve spent 3 years glued to your husband’s side caring for him and you are breaking down. Anyone would.
You may find this article helpful: https://www.agingcare.com/articles/compassion-fatigue-caring-too-much-196224.htm
Take care of yourself, my friend. By doing so you are taking care of your husband. see more
Question
I'm unsure how to keep from losing everything while taking care of my father?
I'm so sorry. Watching your father like this and then worry about money is horrible. Most of us completely understand since we've... I'm so sorry. Watching your father like this and then worry about money is horrible. Most of us completely understand since we've been in similar situations.
It seems as though you get along with your siblings and your dad won't live long enough for Medicaid, so if everyone agrees, including your dad when he's lucid, maybe you can be paid out of his funds. If the family agrees to this, have an agreement notarized. Perhaps the estate attorney who drew up the will and other legal documents can give you some advice.
If your dad may live long enough for all of his money to be used up, then you may have to be dealing with Medicaid. In this case you'd need an elder law attorney.
Good luck. This is a scary and heartbreaking place to be,
Carol see more
It seems as though you get along with your siblings and your dad won't live long enough for Medicaid, so if everyone agrees, including your dad when he's lucid, maybe you can be paid out of his funds. If the family agrees to this, have an agreement notarized. Perhaps the estate attorney who drew up the will and other legal documents can give you some advice.
If your dad may live long enough for all of his money to be used up, then you may have to be dealing with Medicaid. In this case you'd need an elder law attorney.
Good luck. This is a scary and heartbreaking place to be,
Carol see more
Question
Where to find information on estate recovery from Medicaid?
It depends on assets such as a home. If there are no assets there's nothing to recover. If you are the person who set up Medicaid you... It depends on assets such as a home. If there are no assets there's nothing to recover.
If you are the person who set up Medicaid you must have had a contact with social services (or something comparable). That contact can help you. Otherwise go to www.aging.gov and find Indiana under state resources. You'll see a long list of sites for Indiana so you should find local guidance there.
It could be that you are worrying about nothing - it simply depends on if there is anything to recover.
Good luck,
Carol see more
If you are the person who set up Medicaid you must have had a contact with social services (or something comparable). That contact can help you. Otherwise go to www.aging.gov and find Indiana under state resources. You'll see a long list of sites for Indiana so you should find local guidance there.
It could be that you are worrying about nothing - it simply depends on if there is anything to recover.
Good luck,
Carol see more
Question
How do I stop being resentful and see past abuse at times when I am doing something for my mom that she has sh...
DDDuck, sadly this attitude has been verbally beaten into you your whole life. To try and change that now will be a huge challenge. Most... DDDuck, sadly this attitude has been verbally beaten into you your whole life. To try and change that now will be a huge challenge. Most people require professional counseling in order to accept soul deep that they are good and worth people. It's likely that your mother was treated the same way when she was young and she's passing it on. She's not a horrible person but she's ruining your life.
As LorieB quote (many have said) "You can't change other people, you can only change the way you react to them." Read Lorrie's response since she seems to have pulled herself out of a similar situation.
I hope that you can get this in hand enough so that you can say I'm leaving for awhile, and go to regular counseling sessions. In the end, you are likely to have to find separate living situations. I hope that you aren't financially obligated to live with your mom. If you are, then ask for help with that, too. Local family service organizations are a good free or sliding scale place to start.
Take care of yourself first!
Carol see more
As LorieB quote (many have said) "You can't change other people, you can only change the way you react to them." Read Lorrie's response since she seems to have pulled herself out of a similar situation.
I hope that you can get this in hand enough so that you can say I'm leaving for awhile, and go to regular counseling sessions. In the end, you are likely to have to find separate living situations. I hope that you aren't financially obligated to live with your mom. If you are, then ask for help with that, too. Local family service organizations are a good free or sliding scale place to start.
Take care of yourself first!
Carol see more
Question
What is the best way to approach my mother needing help?
There are some good suggestions here. It seems to me that accompanying your mom to the doctor is number one. She may not need to go often,... There are some good suggestions here. It seems to me that accompanying your mom to the doctor is number one. She may not need to go often, but she needs a yearly checkup if nothing else. You could write the doctor ahead of time and say that she is still driving and won't accept any help. The same letter could list the negative changes that you see. He or she may have some suggestions for you such as in-home help.
Your mother has lived a long time in what seems to be remarkable health. While I don't believe in numbers as an indicator of when to quit driving, I'd say it would be exceptionally rare for someone 98 to be able to drive safely, so a doctor should back you up there.
A care manager is also a good suggestion. Often older people respond better to a third part than to their own "children." I really can't blame them. They want independence and why wouldn't they? If a third party offers suggestions, a few changes may be more welcome than the same changes coming from you.
This may seem unfair but to her you’re still her kid. There are family dynamics involved. A care manager would be an “official” who could help her with decisions and then your input may be much more welcome.
If you haven't already talked about to your mother about what a quality life is to her, then you need to do that. I've seen people in their late 80s denied their one cup of coffee in a day when that was one of the few things that the person still enjoyed. The coffee may or may not be good for the person, but if there is nothing that brings pleasure why fight to live?
You, punkjean, sound wonderful and respectful of your mother's rights so I have no doubt you'll do well in compromising. Her safety is important, but living her life as she chooses is also important. If these changes you are seeing are dementia, you may have to get more forceful in the future. For now, work with a third party and see how far you can get with keeping her happy while you protect her from the worst of the issues that could cause harm.
Babalu suggested the book "On Being Mortal." I think every caregiver should read it as well s their aging parents. Our culture has much to learn about quality of life vs. just existing.
Take care and keep being such a great daughter,
Carol see more
Your mother has lived a long time in what seems to be remarkable health. While I don't believe in numbers as an indicator of when to quit driving, I'd say it would be exceptionally rare for someone 98 to be able to drive safely, so a doctor should back you up there.
A care manager is also a good suggestion. Often older people respond better to a third part than to their own "children." I really can't blame them. They want independence and why wouldn't they? If a third party offers suggestions, a few changes may be more welcome than the same changes coming from you.
This may seem unfair but to her you’re still her kid. There are family dynamics involved. A care manager would be an “official” who could help her with decisions and then your input may be much more welcome.
If you haven't already talked about to your mother about what a quality life is to her, then you need to do that. I've seen people in their late 80s denied their one cup of coffee in a day when that was one of the few things that the person still enjoyed. The coffee may or may not be good for the person, but if there is nothing that brings pleasure why fight to live?
You, punkjean, sound wonderful and respectful of your mother's rights so I have no doubt you'll do well in compromising. Her safety is important, but living her life as she chooses is also important. If these changes you are seeing are dementia, you may have to get more forceful in the future. For now, work with a third party and see how far you can get with keeping her happy while you protect her from the worst of the issues that could cause harm.
Babalu suggested the book "On Being Mortal." I think every caregiver should read it as well s their aging parents. Our culture has much to learn about quality of life vs. just existing.
Take care and keep being such a great daughter,
Carol see more
Question
Gastric feeding tube and mother a with moderate dementia?
I'm so sorry that you are faced with this. It's a horribly dilemma for you. If there are no advanced directives against feeding... I'm so sorry that you are faced with this. It's a horribly dilemma for you.
If there are no advanced directives against feeding tubes (which, in this case would likely fall into extreme measures) then you'll probably have to follow through with the skilled nursing care. Pam has the background on this, so read her answer.
If this were me or someone I loved, I'd opt for hospice care, but then I don't know the full story for your situation.
This is a supreme example of getting down in writing the wishes of the individual under differing circumstances before these things happen.
Talk things through with the doctor and no matter what your decision is ask for palliative care for your mom. Palliative care is comfort care but can still be used with feeding tubes and other measures that keep the body alive.
Please keep us posted on how you are doing,
Carol see more
If there are no advanced directives against feeding tubes (which, in this case would likely fall into extreme measures) then you'll probably have to follow through with the skilled nursing care. Pam has the background on this, so read her answer.
If this were me or someone I loved, I'd opt for hospice care, but then I don't know the full story for your situation.
This is a supreme example of getting down in writing the wishes of the individual under differing circumstances before these things happen.
Talk things through with the doctor and no matter what your decision is ask for palliative care for your mom. Palliative care is comfort care but can still be used with feeding tubes and other measures that keep the body alive.
Please keep us posted on how you are doing,
Carol see more
Question
Her sodium level is just a little bit low. Could it cause her confusion?
My father-in-law was hospitalized (this was years ago) for fainting and other issues. It turned out it was simply low potassium. As Bablou... My father-in-law was hospitalized (this was years ago) for fainting and other issues. It turned out it was simply low potassium.
As Bablou so wisely said sodium is an electrolyte (as is potassium). Balance of electrolytes is key. Another thing about sodium - it's being found in some studies that older people (in general) shouldn't be on low sodium diets. These one size fits all (and all ages) conclusions can be far off the mark.
The main thing is to go back to the doctor with your mother and say that she is not doing well. There is confusion. Could this be from an imbalance of some kind? An infection? A medication? Blood test can tell a lot, but the tests need to be read by a skilled professional who knows the meaning of the full panel.
Keep at it before you let them brush her off as having confusion because of "aging" or even dementia. Everything needs to be checked before coming to such a conclusion.
We'd love an update on what happens,
Carol see more
As Bablou so wisely said sodium is an electrolyte (as is potassium). Balance of electrolytes is key. Another thing about sodium - it's being found in some studies that older people (in general) shouldn't be on low sodium diets. These one size fits all (and all ages) conclusions can be far off the mark.
The main thing is to go back to the doctor with your mother and say that she is not doing well. There is confusion. Could this be from an imbalance of some kind? An infection? A medication? Blood test can tell a lot, but the tests need to be read by a skilled professional who knows the meaning of the full panel.
Keep at it before you let them brush her off as having confusion because of "aging" or even dementia. Everything needs to be checked before coming to such a conclusion.
We'd love an update on what happens,
Carol see more
Question
Dad wants a wife and isn't shy about telling a woman he would like for her to be his wife. Does anyone have th...
I'd say that much depends on how aggressive he is. Most people are understanding if an elderly person says something like that. Try to... I'd say that much depends on how aggressive he is.
Most people are understanding if an elderly person says something like that. Try to distract your dad when he does so and then quietly mention his dementia to the woman as you lead your dad away.
However, if you dad is very aggressive you may have to do as Pam mentioned. If he grabs at women or physically tries to connect, you may have to limit his outings.
This is common and terribly sad. Trained caregivers know how to deal with this behavior, but people in a store should be able to shop with some semblance of peace.
Take care of yourself. We understand how hard this is.
Carol see more
Most people are understanding if an elderly person says something like that. Try to distract your dad when he does so and then quietly mention his dementia to the woman as you lead your dad away.
However, if you dad is very aggressive you may have to do as Pam mentioned. If he grabs at women or physically tries to connect, you may have to limit his outings.
This is common and terribly sad. Trained caregivers know how to deal with this behavior, but people in a store should be able to shop with some semblance of peace.
Take care of yourself. We understand how hard this is.
Carol see more
Question
I am her primary caregiver 24/7 lately she's been making some outrageous financial decisions?
As Babalou said, it's not all about memory.There are many types of dementia and many stages in each. ADcaregivers gave some excellent... As Babalou said, it's not all about memory.There are many types of dementia and many stages in each.
ADcaregivers gave some excellent tips. Sometimes a small amount of money in a limited account can help control spending for awhile. Eventually, handling money at all becomes impossible and caregivers need to protect all accounts. I gave my dad outdated credit cards for his wallet just so he felt he had them. That was a temporary solution but most are.
I want to address MotherDuck about her feelings. Many people hate what they consider "lying" to their parents. This isn't lying. This is about compassion for someone with a broken brain. The article below may help you accept this need:
https://www.agingcare.com/articles/validation-therapy-for-dementia-166707.htm
Great answers and comments from everyone about a common, frustrating problem.
Take care of yourselves,
Carol see more
ADcaregivers gave some excellent tips. Sometimes a small amount of money in a limited account can help control spending for awhile. Eventually, handling money at all becomes impossible and caregivers need to protect all accounts. I gave my dad outdated credit cards for his wallet just so he felt he had them. That was a temporary solution but most are.
I want to address MotherDuck about her feelings. Many people hate what they consider "lying" to their parents. This isn't lying. This is about compassion for someone with a broken brain. The article below may help you accept this need:
https://www.agingcare.com/articles/validation-therapy-for-dementia-166707.htm
Great answers and comments from everyone about a common, frustrating problem.
Take care of yourselves,
Carol see more
So tired, need to get away a few hours but how?
Please look at placing him in a nursing home. It doesn't sound as if you have a lot in assets, Medicaid has a program that will help you live decently with what you have left and you'd have your life again so that you can have surgery. Your husband would have care and you can visit as often as you are able.
You can find some resources by going to www.aging.gov and finding your state. This will give you a long lists of possible resources. Another option is your Area Agency on Aging. Someone needs to help you find a solution.
Take care of yourself. Your husband won't have anyone if you go down.
Carol see more