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January 22nd, 2018

1/22/2018

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Religious and spiritual beliefs and practices are important in the lives of many of us. When we get older, we reflect back on our lives and also look forward to a sense of meaning, purpose and connectedness in aging. Some of that involves deciding what we want to hold on to or let go of.
 
So many of Ebenezer’s new residents have to engage in the process of holding on and letting go simply by moving into a smaller apartment than the home they had previously lived in.
 
“What do we do with the desk that won’t fit in? How about the Holiday decorations – maybe our daughter and son-in-law could use them for their house? What will it be like to get to know all of these other people?”
 
While this process can be quite painful, it also prepares us for a journey of holding on and letting go of other things. Which unresolved conflicts prevent us from feeling at peace? Can we let them go? Can we seek reconciliation?
 
According to a Gallop poll, the four major spiritual concerns Americans have about aging, death and dying are:
  • Forgiveness by God or what one holds sacred
  • Reconciliation of broken relationships
  • Giving and receiving forgiveness for past offenses
  • Having a blessing from one’s loved ones.
 
These important concerns can be engaged through our spiritual or religious practices. Prayer, meditation, pilgrimages, fasting, and reaching out to neighbors can be very significant religious practices at any stage in one’s life. Spiritual practices are equally diverse and may include meditation, yoga, walks in nature, appreciation of art, music, joining with others for a common purpose. In addition, writing a legacy document or videotaping an autobiography can be quite meaningful for those creating it and those with whom it is shared.
​
The magazine “Real Simple” published an article in 2005 titled “Getting to know you” by Erik Jackson. He starts off by saying: 
“Photo albums? Check.
Family Tree? Got it.
A deeper understanding of our relatives and friends?
That starts here.”

 
He then lists many questions as conversation starters or almost as an interview format that a good friend, spouse, sibling, or other loved one can ask. Some unique questions are: What is the bravest thing you have ever done? Was there one person who had a big impact on your working life, like a mentor? What are the secrets to a good marriage or relationship? What have you always regretted not asking your parents? 
 
This process of making meaning out of one’s life can be a source of hope, strength and peace. It can bring us the depth of love and connection that we may yearn for. 

--Rev. Mirjam Berger
Ebenezer Corporate Director of Spiritual Health
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Veteran Benefit: Aid and Attendance

1/15/2018

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​If you or your spouse is a veteran and needing extra assistance, you may be eligible for a benefit called "Aid and Attendance." Provided below is information from the U.S. Department of Veterans Affairs on eligibility for Aid and Attendance.

Aid & Attendance and Housebound
Veterans and survivors who are eligible for a VA pension and require the aid and attendance of another person, or are housebound, may be eligible for additional monetary payment. These benefits are paid in addition to monthly pension, and they are not paid without eligibility to Pension.
Since Aid and Attendance and Housebound allowances increase the pension amount, people who are not eligible for a basic pension due to excessive income may be eligible for pension at these increased rates. A Veteran or surviving spouse may not receive Aid and Attendance benefits and Housebound benefits at the same time.

Aid & Attendance (A&A)
The Aid & Attendance (A&A) increased monthly pension amount may be added to your monthly pension amount if you meet one of the following conditions:
  • You require the aid of another person in order to perform personal functions required in everyday living, such as bathing, feeding, dressing, attending to the wants of nature, adjusting prosthetic devices, or protecting yourself from the hazards of your daily environment
  • You are bedridden, in that your disability or disabilities requires that you remain in bed apart from any prescribed course of convalescence or treatment
  • You are a patient in a nursing home due to mental or physical incapacity
  • Your eyesight is limited to a corrected 5/200 visual acuity or less in both eyes; or concentric contraction of the visual field to 5 degrees or less

Housebound
​This increased monthly pension amount may be added to your monthly pension amount when you are substantially confined to your immediate premises because of permanent disability.

How to Apply
You may apply for Aid and Attendance or Housebound benefits by writing to the Pension Management Center (PMC) that serves your state. You may also visit your local regional benefit office to file your request. You can locate your local regional benefit office using the VA Facility Locator.
You should include copies of any evidence, preferably a report from an attending physician validating the need for Aid and Attendance or Housebound type care.
  • The report should be in sufficient detail to determine whether there is disease or injury producing physical or mental impairment, loss of coordination, or conditions affecting the ability to dress and undress, to feed oneself, to attend to sanitary needs, and to keep oneself ordinarily clean and presentable.
  • Whether the claim is for Aid and Attendance or Housebound, the report should indicate how well the applicant gets around, where the applicant goes, and what he or she is able to do during a typical day. In addition, it is necessary to determine whether the claimant is confined to the home or immediate premises.

-Information provided by The U.S. Department of Veterans Affairs
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When Should You Move Your Parent To Memory Care?

1/8/2018

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There could come a time when your parent with Alzheimer's disease or another type of dementia will need more care than can be provided at home. During the middle and late stages of dementia, sometimes 24-hour supervision is required to ensure the person’s safety.  As dementia progresses further, round-the-clock care requirements become more intensive.

Making the decision to move a parent into a specialized memory care environment may be difficult, as it is tough to suddenly be faced with a decision that makes it feel like YOU are now in a parental role.  But it is important to consider whether or not it is possible to continue to provide the level of care needed in the person’s home.  
The questions below, from the Alzheimer’s Association website, are ones to consider when determining if a move to residential care is a good option:
  • Is my mom or dad becoming unsafe in her or his current home? Is s/he getting lost in the neighborhood, or in the home itself?  Are you worried about the person wandering at night? Is crossing the street safely an issue?

  • Is the health of my parent, my own health, or the health of my other parent at risk?  This is a major consideration.  Caregiver stress can be deadly.  There are caregivers who actually die before their loved ones, because they are determined to do it all and once promised the person “they would never have to move to a home”.  Please consider that this is a situation neither party was thinking about when that promise was made.  You  want to be able to be the daughter, or the son, or you want your other parent to be the  wife, or the husband to the person with dementia. Being in the caregiver role can easily drain all energy from your rightful role.

  • Are my parent’s care needs beyond my physical abilities or the abilities of my other parent?  A doctor’s opinion might come in handy here, so that you, the son or daughter, have some professional backup for your own assessment of the situation.

  • Am I or is my other parent becoming a stressed, irritable and impatient caregiver?  Staff members who work with persons with dementia are trained to not take things personally, to answer repeated questions patiently, and to empathize even in the midst of challenging situation. It is typically very difficult, especially at first, for family members  to adjust to the changes in their loved one.

  • Am I neglecting work or family responsibilities in the process of caring for my mom or dad?  If you are not sure who you can talk to about any of the issues listed here, this, do not hesitate to call the Alzheimer’s Association’s 24-hour help line as you wrestle with this or any dementia-related issue:  1-800-272-3900.

  • Would the structure and social interaction at a care facility benefit my parent? Sometimes the person will flourish in an environment where there is more structure and  interaction with others.  A lack of structure and routine is wearing and stressful for the  person with dementia. Sometimes people adjust surprisingly quickly to a new  environment, because they have less time on their own in which to become confused about what should happen next.  Others take longer to get used to a new routine.  Most people seem to settle in within 3-4 weeks.    

Even if you plan ahead for a move, making this transition can be incredibly stressful.  You may have an abundance of conflicting emotions.  You may feel relieved and guilty at the same time. These feelings are common. Regardless of where you choose to have the person cared for, it’s good to keep your focus on making sure your parent’s needs are well met. 
 
Please see http://www.alz.org/care/alzheimers-dementia-residential-facilities.asp for additional information.


--Marysue Moses, Ebenezer Dimensions Program Coordinator
8 Comments

In This Together

1/1/2018

1 Comment

 
If you have ever surfed websites of senior housing options, I bet you have frequently run into the term “person-centered care” which we owe to Dr. Thomas Kitwood, a British physician who focused on the importance of remembering that a person with dementia is first and foremost a PERSON with particular needs, challenges, strengths and preferences. 

Cannot expect persons with dementia to think like we do
It is also due to Dr. Kitwood’s brilliant work that nurses are no longer trained to try to orient persons with dementia to reality, e.g., “No, no, Mrs. Jones, it’s 2017 now – actually your mother is dead, and the farm has been sold!” Thank goodness for Tom Kitwood! He helped us understand that we cannot expect persons with dementia to think like we do. As I’ve heard nursing home operator and author Megan Carnarius say, “We need to cross to their side of the street.” People with dementia simply cannot come over to ours. We need to give them responses that make sense with the way in which they understand the world. 

Relationship-based care
Dementia expert Elion Caspi encourages us to also think about dementia care as “relationship-based care.”  If we do not maintain relationship and genuine connection with persons with dementia, trust wears thin. As a result, it becomes challenging for persons with dementia to accept the care they need.  

Lost in the grief
It is completely understandable that care partners are exhausted. They often get caught up in the grief of losing the precise relationship they had with their loved one before dementia was part of the picture. All too often, people become angry and bitter, even to the point of saying things such as “Alzheimer’s is worse than death.” That is a direct quote from the despondent husband of a wonderfully clever woman; let’s call her “Pam,” with whom I worked for some years. What a heartbreaking pronouncement from her husband! At this point, Pam still loved to share opinions and insight, sing Broadway tunes, reminisce, walk, dance, and hold hands.

A person is NOT their Alzheimer's disease any more than a person who has cancer is their cancer!
Those of us who have had family members with dementia or other progressive diseases do understand from whence that sentiment arises.  However, it is ultimately not a helpful one.  Nor is it accurate. It implies that we might as well give up on a person who is still very much alive. This could not be further from the truth. A person is NOT their Alzheimer’s disease any more than a person who has cancer IS their cancer. The person, an intact spiritual being, is still there, though many of their needs have changed dramatically. We do our loved ones a disservice if we refuse to rise to the occasion of their increased needs. 

Maintain connections along the way
There are many gifts to be gained by accepting where the person is at, through each and every phase of their dementia experience. There is connection to maintain all along the way. How we connect will vary with different types and different phases of dementia, but in general, smiling, eye contact, gentle touch and approach, curiosity, acceptance of where the person is, conversation about things that are meaningful to the person, sharing laughter, singing, enjoying simple pleasures, giving compliments, promoting calm, validating the person’s feelings, doing things just the way the person likes, making things easier for them, reminiscing, having fun together, sparking creativity, enjoying humor….well, the list of what can be done to maintain a healthy, nurturing relationship goes on and on.

Responding to the world from an earlier developmental time
In short, we can treat the person like a PERSON, and remember that even though this person is losing skills, even though this person may enjoy and indeed benefit from things that children like, this person is still an adult who is simply responding to the world from an earlier developmental time. This person still has strengths and skills we must actively encourage and appreciate in order for them to have a meaningful life.     

Language is powerful
Did you notice that I’ve been using the term “care partner” rather than “caregiver?”  Language is powerful. When the relationship between a person with dementia and someone caring for them is viewed more as a partnership, what’s implied is that both persons have something to give. Think about it…What might persons with dementia still have to offer us, their care partners?

Some bonds remain unbreakable
They can give valuable input as to what they like and what they don’t like. They can lend us wisdom from past experience; they can share memories of olden days, with humor and perspective. They can inspire us with their courage and resilience. They can give us love. In this process, we may be surprised at how flexible our own capacity to love may become. Even in the late stage of their dementia, our loved one may remind us how some bonds remain unbreakable. Caring for persons with dementia may give us more patience and more appreciation for wordless communication and for life than we’ve ever known.
​ 
We are in this together
Thinking about our relationship as a partnership will help make us more open to a person’s participation and input. We just might respect, value and love this person all the more.  We are not the same as this person, and we have each been impacted by dementia and changed forever in vastly different ways, but surely we are in this together.      
 
​
--Marysue Moses, Ebenezer Dementia Care Program Coordinator          
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Discrimination is Against the Law. We comply with applicable Federal civil rights laws. We do not discriminate against, exclude or treat people differently because of race, color, national origin, age, disability, sex or sexual orientation..

Ebenezer Senior Living
​Savage Senior Living at Fen Pointe is managed by Ebenezer, Minnesota’s largest senior living operator. Ebenezer is the senior housing division of Fairview Health Services and has 100 years of experience serving older adults.

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952-808-8725

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5950 130th Lane West
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