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
How to deal with family member who came to visit her mother once in awhile, and advising me how to approach he...
I agree that there's no reason to spoil good memories with "facts." You sound like a fantastic caregiver who really cares but... I agree that there's no reason to spoil good memories with "facts." You sound like a fantastic caregiver who really cares but you weren't in her family for years so you can genuinely say "I'm not certain where they are" or something similar when they talk about someone who you know died years ago.
It's true that the family, or whoever pays you, directs the care. You are to be admired for trying to get along with them for everyone's sake. It's too bad you can't be cloned.
Take care,
Carol see more
It's true that the family, or whoever pays you, directs the care. You are to be admired for trying to get along with them for everyone's sake. It's too bad you can't be cloned.
Take care,
Carol see more
Question
How do you pick up an elder when they have fallen?
I used to call the EMTs (the fire department) for my mom but she fell so regularly that I could tell that they were finding it too much.... I used to call the EMTs (the fire department) for my mom but she fell so regularly that I could tell that they were finding it too much. I'd say that she doesn't need the full brigade, she just needs to get up, but that's not how they operate. Her weekly (or more) falls were the deciding factor in her going into the same nursing home where my dad lived.
I jokinging have said that every city needs a person who will simply go and help pick up people who have fallen and can't get up with the help of the caregiver. This really isn't so far fetched but it's unlikely to happen if only for liability reasons.
Good luck with our present problems. It's a big issue for caregivers.
Carol see more
I jokinging have said that every city needs a person who will simply go and help pick up people who have fallen and can't get up with the help of the caregiver. This really isn't so far fetched but it's unlikely to happen if only for liability reasons.
Good luck with our present problems. It's a big issue for caregivers.
Carol see more
Question
My husband has cognitive/memory issues and now he repeats himself with no recollection of doing so. What can I...
Often a person can be convinced to see a doctor about a regular health issue such as blood pressure. If you can get him to an appointment... Often a person can be convinced to see a doctor about a regular health issue such as blood pressure. If you can get him to an appointment for something like a yearly physical or a medication check, then write the doctor ahead about your real concern. This will give the doctor a heads up. There are some subtle in-office things that a good doctor can look for. Don't mention to your husband anything about a cognitive check. Just act like it's an ordinary appointment that one would have yearly.
The checkup could possibly find a reversible reason for his changes. Also, if a doctor says "I want to refer you to a specialist for more testing" the person will do it when if a family member tries this the answer is "no."
Good luck to you. This is a common issue and a sad one since early detection is better all around. Please let us know if you are (or are not) making progress.
Carol see more
The checkup could possibly find a reversible reason for his changes. Also, if a doctor says "I want to refer you to a specialist for more testing" the person will do it when if a family member tries this the answer is "no."
Good luck to you. This is a common issue and a sad one since early detection is better all around. Please let us know if you are (or are not) making progress.
Carol see more
Question
My Mom says, "I just want to go home." Is she reverting to being a little girl or an adult who misses her old...
In the mid to late stages of the Alzheimer’s the desire to "go home" is often more about a feeling of safety and security than a... In the mid to late stages of the Alzheimer’s the desire to "go home" is often more about a feeling of safety and security than a place but whatever is at the base of it, this constant plea to go home is agonizing for the caregiver to hear.
People differ as to the phase they are in when (if) they go through this and there aren't any clear answers except to be patient with the person and try to distract them. They need to feel secure (as many people do when they are children). That, plus the fact that many with AD remember more about decades past than the near past, often brings them cognitively back to their childhood home (as it was decades ago). Even if the caregiver could possibly replicate that home and take their loved one to visit, the plea to go home would not stop.
It's a normal phase and a very difficult one. Compassion, distraction, validation - all of the things we as caregivers practice help but there is little that will make it go away.
Read the whole thread for some great ideas!
Carol see more
People differ as to the phase they are in when (if) they go through this and there aren't any clear answers except to be patient with the person and try to distract them. They need to feel secure (as many people do when they are children). That, plus the fact that many with AD remember more about decades past than the near past, often brings them cognitively back to their childhood home (as it was decades ago). Even if the caregiver could possibly replicate that home and take their loved one to visit, the plea to go home would not stop.
It's a normal phase and a very difficult one. Compassion, distraction, validation - all of the things we as caregivers practice help but there is little that will make it go away.
Read the whole thread for some great ideas!
Carol see more
Question
My husband needs to be into a nursing facility but worried how this affects me financially?
Clare, considering your age I think you'd be wise to seek help from an elder law attorney. There are safety nets in place for you to... Clare, considering your age I think you'd be wise to seek help from an elder law attorney. There are safety nets in place for you to keep your home, but they were set up more for very elderly people. You are still young so you need expert help. My heart goes out to you for having to go through this at your age.
We'd love to hear how you are doing when you have time to check back.
Carol see more
We'd love to hear how you are doing when you have time to check back.
Carol see more
Question
My medical provider is forcing me to use a certain Medicare advantage insurance plan, is that legal?
Medicare Advantage plans are different than plain Medicare in that Advantage plans include a private insurance segment while Medicare is... Medicare Advantage plans are different than plain Medicare in that Advantage plans include a private insurance segment while Medicare is completely federal.
The plain Medicare supplements must provide certain things to be considered viable for that Medicare plan. I’d be wary of any type of pressure to sign up for a particular plan.
I'm not a Medicare expert but my guess would be that Advantage plans - like any private plans - may have more leeway in deciding who they cover. Plain Medicare (Plan F is the most expensive supplement but great since there are no co-pays) will supplement whatever Medicare covers as long as the facility takes Medicare.
Advantage plans generally cover more things such as vision and sometimes dental but there are copays and you are dealing with a private insurer with more clout in the final page than with straight Medicare so you need to choose carefully. As was mentioned, doctors may have to sign up for providing care for each plan. I'm not sure how that works.
All of the Medicare and Medicare Advantage choices can be complicated so making these choices is easier with someone who knows your state and federal laws as well as all of the possible plans. The problem is finding someone who can help but doesn't have something to gain by steering you toward a certain plan.
There were some excellent answers here. As always, I learned just from reading.
Thanks to this wonderful group of people.
Carol see more
The plain Medicare supplements must provide certain things to be considered viable for that Medicare plan. I’d be wary of any type of pressure to sign up for a particular plan.
I'm not a Medicare expert but my guess would be that Advantage plans - like any private plans - may have more leeway in deciding who they cover. Plain Medicare (Plan F is the most expensive supplement but great since there are no co-pays) will supplement whatever Medicare covers as long as the facility takes Medicare.
Advantage plans generally cover more things such as vision and sometimes dental but there are copays and you are dealing with a private insurer with more clout in the final page than with straight Medicare so you need to choose carefully. As was mentioned, doctors may have to sign up for providing care for each plan. I'm not sure how that works.
All of the Medicare and Medicare Advantage choices can be complicated so making these choices is easier with someone who knows your state and federal laws as well as all of the possible plans. The problem is finding someone who can help but doesn't have something to gain by steering you toward a certain plan.
There were some excellent answers here. As always, I learned just from reading.
Thanks to this wonderful group of people.
Carol see more
Question
My wife with Alzheimers is having a hard time trying to feed herself, is this normal for her condition?
Most people eventually get to a point when not only are the utensils unfamiliar, but so is the food. Also, the brain damage can interfere... Most people eventually get to a point when not only are the utensils unfamiliar, but so is the food. Also, the brain damage can interfere with the taste of food making something they love into something they eventually find bland or simply don't like. It's all part of the process.
Keep following this thread since excellent responses will continue to come in from readers with varied experiences.
Take care,
Carol see more
Keep following this thread since excellent responses will continue to come in from readers with varied experiences.
Take care,
Carol see more
Question
Does changing things in the house confuse people with Alzheimer's?
There are wonderful answers here from this compassionate group. I agree with the overall feeling that while the change isn't... There are wonderful answers here from this compassionate group. I agree with the overall feeling that while the change isn't necessarily right for your mom - it's rather like moving her from place to place - your dad has to stay sane. So my first thoughts were this isn't good. However, I've modified that after reading some of the wise responses. If remodeling helps your dad and in the end he's a better caregiver, then I'm not sure you should try to intervene.
Perhaps he realizes that he will eventually need to sell the house and he's more likely to get his money out of it if it's updated. He obviously needs something to do, and at least this is productive.
If this starts to truly agitate your mother, he may have to let the remodeling go for awhile. If your mom just thinks is new but isn't overly bothered, maybe it's not doing too much harm (it can’t be positive but what is perfect?).
The downward spiral for your mom is going to happen no matter what is done or not done. Yes, this could be hastening her decline. However, two people's lives need to be considered.
I wish there were a clear answer, but with most things concerning dementia, every day is different and every person is different. I'd talk with your dad and ask him to watch for agitation and anxiety. If the remodeling isn't pushing your mother over the edge in that way, then - considering that this is likely good for your dad - maybe it's as okay as things can be.
You're are good person to be considering both of them and not blaming your dad You are right. It's their house and that means his as well as your moms.
Take care of yourself and try to keep balanced. We are with you.
Carol see more
Perhaps he realizes that he will eventually need to sell the house and he's more likely to get his money out of it if it's updated. He obviously needs something to do, and at least this is productive.
If this starts to truly agitate your mother, he may have to let the remodeling go for awhile. If your mom just thinks is new but isn't overly bothered, maybe it's not doing too much harm (it can’t be positive but what is perfect?).
The downward spiral for your mom is going to happen no matter what is done or not done. Yes, this could be hastening her decline. However, two people's lives need to be considered.
I wish there were a clear answer, but with most things concerning dementia, every day is different and every person is different. I'd talk with your dad and ask him to watch for agitation and anxiety. If the remodeling isn't pushing your mother over the edge in that way, then - considering that this is likely good for your dad - maybe it's as okay as things can be.
You're are good person to be considering both of them and not blaming your dad You are right. It's their house and that means his as well as your moms.
Take care of yourself and try to keep balanced. We are with you.
Carol see more
Question
I pay someone to 'eldersit' my elderly mom. How to arrange tax issues?
If the sitter is there often you may want to check state regulations which may differ from federal.
Question
Is it practical to move an individual who is diagnosed with down syndrome and dementia?
I agree with Churchmouse. It's rarely a good idea to move someone in this stage of dementia. It sounds as if good care is already... I agree with Churchmouse. It's rarely a good idea to move someone in this stage of dementia. It sounds as if good care is already provided. If the agency doesn't have a good reason, I'd rather see the person remain.
It could be that someone needs this space and the move would seem beneficial to everyone, but every aspect has to be considered.
You are kind to be so concerned.
Carol see more
It could be that someone needs this space and the move would seem beneficial to everyone, but every aspect has to be considered.
You are kind to be so concerned.
Carol see more
Question
My mom (83) has vascular Parkinson's, dementia and fractured both hips a little over a year apart. Any advice?
While it's not always the case that non-profits are better, my own experience has been to go for them rather than for-profits. My own... While it's not always the case that non-profits are better, my own experience has been to go for them rather than for-profits. My own experience has been with a wonderful non-profit for whom I can't say enough good things. We had a for-profit in our community for less than a year and they didn't get such good reviews.
I do like the hospice idea for a woman with all of these issues - taking into consideration her age. If this were me, I'd choose hospice care.
Take care of yourself,
Carol see more
I do like the hospice idea for a woman with all of these issues - taking into consideration her age. If this were me, I'd choose hospice care.
Take care of yourself,
Carol see more
Question
Is it worth it to pay a lawyer to help file for Medicaid?
A great deal depends on the assets and also the state. All trusts are not "protected" from Medicaid. If this is a complicated... A great deal depends on the assets and also the state. All trusts are not "protected" from Medicaid. If this is a complicated situation, then an elder law attorney is probably a good idea. Having recommendations is also good. As Bob mentioned, you can make an appointment with Medicaid to ask questions so that is an option.
Most of the people posting seem to think it's a good idea. I simply paid out of pocket but much more is known now so if I'd had it to do over maybe I'd do it differently.
Good luck,
Carol see more
Most of the people posting seem to think it's a good idea. I simply paid out of pocket but much more is known now so if I'd had it to do over maybe I'd do it differently.
Good luck,
Carol see more
Question
Is there anything else I can do to prevent my father developing bed sores?
This article may help: https://www.agingcare.com/articles/What-Caregivers-Need-to-Know-About-Bed-Sores-203147.htm
Good luck,
Carol
Good luck,
Carol
Question
Where can you report Assisted Living Billing Fraud and abuse of policy? We cannot afford an attorney.
I'd take this to the state attorney general's office. They could direct you from there. If fraud is going on you shouldn't need... I'd take this to the state attorney general's office. They could direct you from there. If fraud is going on you shouldn't need to hire an attorney. Your state should want to know.
We'd love to hear how this goes.
Take care,
Carol see more
We'd love to hear how this goes.
Take care,
Carol see more
Question
How to take mom on outing from nursing home?
If this is a family gathering, I'd do what Jeannegibbs suggested - take the party to the nursing home. We did that often and the staff... If this is a family gathering, I'd do what Jeannegibbs suggested - take the party to the nursing home. We did that often and the staff was extremely helpful when we needed assistance.
If this is for medical reasons, I agree that you need others to assist you. I'd take my parents in a paratransit bus. They'd be in their wheelchairs, but I'd balance a walker on the handles of the wheelchair for Mom because, with the help of the walker, she could use that bathroom.
I felt that I should have a sign on my back that said "wide load" but it worked - sort of. Bulky and not great, though. At least one other body would have been very helpful.
With your back issues, having other to help is extra important.
I hope that you can find some extra bodies. Please let us know.
Take care,
Carol see more
If this is for medical reasons, I agree that you need others to assist you. I'd take my parents in a paratransit bus. They'd be in their wheelchairs, but I'd balance a walker on the handles of the wheelchair for Mom because, with the help of the walker, she could use that bathroom.
I felt that I should have a sign on my back that said "wide load" but it worked - sort of. Bulky and not great, though. At least one other body would have been very helpful.
With your back issues, having other to help is extra important.
I hope that you can find some extra bodies. Please let us know.
Take care,
Carol see more
Question
Does anyone know if things like a cold, the flu, UTI's etc. take the person with Alzheimer's toward the next l...
Any infection or illness that stresses the body can make set in motion a worsening of Alzheimer's. Flu, pneumonia, untreated UtIs,... Any infection or illness that stresses the body can make set in motion a worsening of Alzheimer's. Flu, pneumonia, untreated UtIs, falls - they all stress the body, so when these people who are already so challenged get sick, they may improve as far as the illness goes but their cognitive ability can decline. Hospital visits are especially bad, so if the person is in a nursing home most illnesses are treated by the staff there rather than hospitalize the person.
Naturally, there are people who come out of these illnesses with no change, but the possibility is always there, especially if they are close to changing stages anyway.
Take care,
carol see more
Naturally, there are people who come out of these illnesses with no change, but the possibility is always there, especially if they are close to changing stages anyway.
Take care,
carol see more
Question
Do seniors go through mood swings to a greater degree than others?
First, we need to understand that the words "seniors" and "dementia" are not interchangeable. Do seniors go through... First, we need to understand that the words "seniors" and "dementia" are not interchangeable. Do seniors go through mood swings more than others? In general, healthy, active seniors who I know are some of the most stable people around. They know what is important and what is not. They have good brains and if they have health issues, they deal with them and continue on.
People with dementia (even younger people who have younger onset Alzheimer's disease) will likely have dramatic mood swings. People who have depression, whatever the cause, or other mental health diseases, are likely to have mood changes. People in chronic pain or who have problems breathing are likely to have mood swings. People who have uncontrolled diabetes or terrible diets may have mood swings. This is true at any age.
Having physical issues addressed and, if cognitive issues are a likely problem having them addressed, is how we can decide if someone who is having major mood issues needs help.
Yes, age is a major risk factor for dementia, so if you have a family member who is getting older and is having mood swings, that person could be in the earlier stages of dementia. Getting checked by a qualified physician is what needs to be done.
I'd love to see everyone who has "difficult" elders be able to accomplish this, but sadly, many elders will refuse to be treated. In that case, those elders will likely be very difficult.Their refusal to get medical help is often part of their disease which makes the whole process horrible for their loved ones.
Carol see more
People with dementia (even younger people who have younger onset Alzheimer's disease) will likely have dramatic mood swings. People who have depression, whatever the cause, or other mental health diseases, are likely to have mood changes. People in chronic pain or who have problems breathing are likely to have mood swings. People who have uncontrolled diabetes or terrible diets may have mood swings. This is true at any age.
Having physical issues addressed and, if cognitive issues are a likely problem having them addressed, is how we can decide if someone who is having major mood issues needs help.
Yes, age is a major risk factor for dementia, so if you have a family member who is getting older and is having mood swings, that person could be in the earlier stages of dementia. Getting checked by a qualified physician is what needs to be done.
I'd love to see everyone who has "difficult" elders be able to accomplish this, but sadly, many elders will refuse to be treated. In that case, those elders will likely be very difficult.Their refusal to get medical help is often part of their disease which makes the whole process horrible for their loved ones.
Carol see more
Question
Do seniors go through mood swings to a greater degree than others?
I'm so proud of the thoughtful and varied answers provided by this compassionate group! Nearly every string gives people some food for... I'm so proud of the thoughtful and varied answers provided by this compassionate group! Nearly every string gives people some food for thought if not a direct answer for their particular problem.
Take care all and keep up the great sharing!
Carol see more
Take care all and keep up the great sharing!
Carol see more
Question
92 year old father has prostate cancer that has spread to bone. Anyone else go through this?
DaughterofAl, It seems that your dad is doing fine and should be allowed to make this decision on his own. His doctor can tell him what to... DaughterofAl, It seems that your dad is doing fine and should be allowed to make this decision on his own. His doctor can tell him what to watch for if the cancer develops but PSA tests are controversial now anyway as to their accuracy. If he's getting his shots he's probably doing what he can. I'd just respect his decision and be thrilled that he's doing so well. see more
Am I selfish for thinking a nursing home with rehab is the best option for my father and not taking care of hi...
Speaking of that love, the very best care he can have now will be provided by professionals. You will be his advocate and his rock through visiting and keeping him connected. But his physical care is complicated and needs trained professionals. This won’t change even with rehab. It could improve, but he’ll continue to need far more care than you can provide.
As was mentioned, the social worker at the rehab/nursing home will be able to help you sort through this. A chaplain may also be able to help.
jeannegibbs put it well when she says that parents want to see their children flourish. Your building your life so that when his time comes he can die in peace will be the greatest gift you can give him. Even if that doesn't seem so now, in the end it is. You are not giving up. You are getting more help - trained help.
If you get a chance, we'd love to hear from you from time to time. We're all pulling for you and your dad.
Take care,
Carol see more