Warning Signs For Helping Elderly Parents

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The Caring Generation® – Episode 27 February 19, 2020 On this caregiver radio program Pamela D. Wilson, caregiving expert talks about Warning Signs for Helping Elderly Parents to stay at home and caring for elderly parents. Nearly 50% of older adults are malnutritioned. Poor nutrition is a warning sign that an elderly parent may be unable to stay at home. Guest Dr. Nicolaas Deutz Director of the Center for Translational Research at Texas A&M shares Solutions for Signs of Malnutrition in Older Adults.

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Warning Signs for Caring for Elderly Parents

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00:04 Pamela D. Wilson: Caregiving can sometimes feel like an impossible struggle. Caregivers may be torn between taking care of loved ones and trying to maintain balance in life. The good news is that it doesn’t have to be that way. The Caring Generation, with host Pamela D. Wilson, is here to focus on the conversation of caring. You’re not alone; in fact, you’re in exactly the right place to share stories and learn tips and resources to help you and your loved ones. So now, please welcome the host of The Caring Generation, Pamela D. Wilson.

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00:44 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert. I’m your host. You’re listening to The Caring Generation radio program, coming to you live from the BBM Global Network Channel 100 and TuneIn radio. The Caring Generation focuses on conversations about health, well-being, caring for ourselves, loved ones, and everything in between. All tied together with a little bit of humor and laughter that are essential to being a caregiver. Take The Caring Generation with you wherever you go on Apple Podcasts, Google Podcasts, Pandora, iHeartRadio, Spotify, Spreaker, Stitcher, SoundCloud, Castbox, and more. Share the program with your elderly parents and family members. You can download a podcast app to their cell phones and show them how to listen. It’s the perfect way to help begin conversations about caregiving by letting me do the talking for you.

01:40 Pamela D. Wilson: Our topic for the show tonight is warning signs for helping elderly parents who want to stay at home. The thought of having to care for elderly parents can be a lot of emotions that can be ups and downs for caregivers. Caregivers worry about the time involved in helping elderly parents and paying for care. Emotional distress happens when caregivers watch the health of an elderly parent decline. Elderly parents, on the other hand, they worry about becoming dependent on adult children and others for care. Elderly parents don’t want to be a burden. During this program, we’ll talk about warning signs for helping elderly parents so that you can be proactive and work with your parents. We’ll also talk about the idea of care forward-thinking to reduce the fear and confidence gaps that come along with being a caregiver and an aging adult.

02:35 Pamela D. Wilson: Poor nutrition is one warning sign for helping elderly parents who want to stay at home. We will talk about good nutrition and the opposite, signs of malnutrition in older adults with Dr. Nicolaas Deutz. He is Director of the Center for Translational Research in Aging and Longevity at Texas A&M. For more than 30 years, Dr. Deutz has researched nutrition, metabolism, and body function associated with chronic disease.

03:05 Pamela D. Wilson: We have more impact on the way that we age than we think. Let’s start with the idea of elderly parents who want to stay at home and events that result in elderly parents moving to a care community or a nursing home. Most elderly parents will do whatever it takes to stay at home. But sometimes we have to remind them what it takes. Because going to a nursing home is a great fear for our elderly parents. As elderly parents experience difficulty with daily activities, also called ADLs, parents become less able to care for themselves and more dependent on caregivers.

Medical Concerns for the Elderly: Should I Take This Seriously or Not?

03:45 Pamela D. Wilson: An activity of daily living is a task like bathing safely instead of falling or slipping in the tub or shower. Dressing is an activity of daily living that can be difficult if an elderly parent has arthritis and can’t easily use buttons or zippers. Or maybe your elderly parent has difficulty bending over to reach to put on shoes or to tie shoelaces. How many of you can easily bend over and touch your toes without falling over? Eating is another activity of daily living that may sound simple. But it is a warning sign for helping elderly parents. Nutrition is a significant contributor to good health and is another warning sign for helping elderly parents who want to stay at home.

04:33 Pamela D. Wilson: If you have an elderly parent with a lot of health issues, who is frail and weak, you may have heard the term ‘failure to thrive’. Failure to thrive is a medical term for elderly parents who have ongoing health issues, who seem to be getting worse instead of getting better.  They’re getting more physically weak, more tired. Malnutrition is a warning sign for helping elderly parents that happens from poor nutrition or having health conditions that make it difficult for the body to process food and nutrition. Is your elderly parent always tired? Physically weak? Depressed? Does your parent have skin wounds that don’t heal or heal slowly? Or, is mom or dad diagnosed with memory loss? Malnutrition can be related to these conditions that present warning signs for helping elderly parents who want to stay at home. You might take an elderly parent to the doctor because you see these warning signs, and you realize that maybe everything isn’t okay.

05:34 Pamela D. Wilson: The doctor says, “Oh well, this happens with aging.” Or, “Your parent is 85. What do you expect?” Don’t let doctors put negative thoughts in your mind that there are no solutions. Every problem has a solution. I prefer to combat this type of old age prejudice with what I call care forward-thinking. Care forward applies to all of us, no matter our age 20, 30, 50, 70. Care forward means that age doesn’t define our abilities or the care or treatment that we should receive. It’s a different way of thinking that sometimes we have to remind ourselves about. Because it’s easy to become negative and worried about everything involved in being a caregiver or in caring for an elderly parent.

06:19 Pamela D. Wilson: Let’s look at the opposite of care forward-thinking so that this idea might be a little easier to understand. How many of you see your parents who want to stay at home, giving off warning signals about health, well-being, safety, or they’re not able to complete activities of daily living? Is mom or dad walking around the house holding on to furniture for balance? Has mom or dad who is physically weak, fallen, and broken a hip? Your thought is, “Well, of course, that fall is no surprise. Mom or dad is physically weak, and they can’t get around the house without holding on to furniture.”

06:55 Pamela D. Wilson: Thinking this way is the opposite of care forward-thinking. You don’t want to be like that physician who says, “Your parent is 85, what do you expect? It’s only going to get worse.” The problem is that family members don’t know to take these warning signs for helping parents seriously. Why? Because we’re not taught to be proactive. We’re not as educated as we could be about the consequences of medical diagnosis. Because it’s easier for most doctors to write a prescription and send people on their way.

07:30 Pamela D. Wilson: Doctors don’t talk seriously to us about how to prevent medical diagnosis, because it’s just not what they do. Elderly parents face the same issues. Parents may be in denial about needing help. Doctors see problems, and they don’t suggest any type of treatment. This thinking pattern is a trap of expectations about aging. Who says a 90-year-old has to be old and frail? Do you look forward to being 90-year-old and frail? Are you looking forward to living in a nursing home? I don’t think so. Care forward-thinking is the idea that we create, and we control what we think about aging.

08:09 Pamela D. Wilson: Why not be the 90-year-old who walks two miles every morning, meets friends for lunch, and volunteers in the afternoon? Warning signs for helping elderly parents who want to stay at home begin with negative thoughts that difficulty performing activities of daily living is normal. These negative thoughts lead to thinking that being physically weak or malnutritioned is just what happens with age. It’s not. Aging does not have to be that way.

08:36 Pamela D. Wilson: Coming up after the break, helpful information to help us take better care of ourselves nutritionally with Dr. Nicolaas Deutz, Director of the Center for Translational Research on Aging and Longevity at Texas A&M. He’ll share thoughts on preventing malnutrition in older adults. This is Pamela D. Wilson on The Caring Generation live on the BBM Global Network Channel 100 and TuneIn radio. Stay with me. We’ll be right back after this break.

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11:02 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert, I’m your host. You’re listening to The Caring Generation coming to you live from the BBM Global Network, Channel 100, and TuneIn Radio. We’re back with Dr. Nicolaas Deutz, Director for the Center for Translational Research in Aging and Longevity, to talk about nutrition. Dr. Deutz, thank you for joining us.

11:23: Dr. Nicolaas Deutz: Thank you.

11:25: Pamela D. Wilson: So, let’s talk about nutrition. Aging includes a loss of muscle mass, lower strength, and greater difficulty with activities of daily living. How does poor nutrition for older adults contribute to these issues?

11:40: Dr. Nicolaas Deutz: Yes, so thank you for having me on the program. Indeed, this is a very important topic. The way I explain this is the following. Older people have just a harder time to move around, so they reduce their activity. By reducing the activity, the body senses that they need to eat less. That is one of the reasons why, for instance, they have less desire to eat. And what an older person usually is doing is just eating less of everything. Which is good for the calories, but not for the protein. So, we did a lot of research and published a lot of research on that to show that actually, the intake of protein in older individuals is lower, and we know that sufficient protein intake relates to healthy muscle. So, by reducing what you eat and not changing what you eat, which means more protein, your muscle gets less nutrients and by that becomes weaker. And because muscle becomes weaker, older individual then even do much more less and then start to eat more less. It’s kind of cycle. So, the point of starting here in my opinion, is actually the activity of old adult, that is so important to maintain.

13:03 Pamela D. Wilson: And so, that kind of leads to this next question. So, let’s say the older adult is not seeing a doctor. What signs would tell an older adult or their caregiver to suspect that poor nutrition might exist? Is it the low activity or something else?

13:18 Dr. Nicolaas Deutz: Yes, low activity. Less strength, weakness, feeling weak, and at a later stage, you will see loss of muscle mass. But when people still have a decent BMI, that is actually hidden. So, we see somebody, and we think, “Oh no, this person is still okay, has a BMI between 25 and 30.” But that person could still have lost a lot of muscle mass and being weak. So, strength and feeling not strong enough is really very important. And of course, lesser strength makes it harder to be active. So reduced activity is then the consequence of that.

13:58 Pamela D. Wilson: And you mentioned the importance of protein. So, I’ve worked with older people for years. Not many primary care physicians offer a lot of nutritional recommendations. They may say, “Oh, go to the store and pick up Ensure or that Boost.” There has to be other nutritional supplements. Does it take seeing someone like you to get these recommendations?

14:19 Dr. Nicolaas Deutz: Now, first of all, we do these recommendations, of course, at many places as we can. But it’s really clear that the education for physicians, nutrition is just no part of it or a very small part. So, the physicians don’t see that as part of their care for the patients. Interesting, very recently, we published in JAMA, a meta-analysis that includes some of my studies and some other studies to show that if you provide sufficient nutrition – protein – and you work in hospitals the state of people that are malnourished; actually, they have a much-reduced mortality. So, nutrition is not just something, just a little bit marginal, no, it really should be part of the care. So, a doctor should really recognize when there is a problem with nutrition and should do recommendations. Now it’s not only Ensure and Boost. I have to be clear. You can actually do the same with your normal diet. There’s no need just to go to nutritional supplement. You can…

15:25 Pamela D. Wilson: So…

15:25 Dr. Nicolaas Deutz:  Well, go to Sam’s Club or Walmart and buy whey protein and add that to your normal nutrition. That would be very helpful already.

15:33 Pamela D. Wilson: That’s what I was going to ask. So whey protein, do you put it in, can you put it on foods, or do you mix it in liquids?

15:39 Dr. Nicolaas Deutz:   You can do whatever you want with it, really. You can even add it to your Diet Coke if you would like to drink that.

15:45 Pamela D. Wilson: Oh. [chuckle]

15:46 Dr. Nicolaas Deutz: It dissolves very well. You can add it to yogurts, to milk, whatever you want. So, it’s kind of experimenting until you have sufficient intake of protein.

15:57 Pamela D. Wilson: Okay, that’s interesting. So, I’ve had clients too that had health conditions, like, I can’t think of a disease, but where they had poor wound healing. And those clients had to go to, and I want to say, wound care doctors to get blood tests for albumin levels. Is that something that doctors typically do, or does there have to be a wound before something like that happens?

16:21 Dr. Nicolaas Deutz: Yes. So many, many years ago, it was said that if you measured the albumin concentration in plasma, that it will give you an indication of malnutrition. But that’s actually not true. So, I think a recent more advanced way of looking at it, is actually, you have to do some screening tools to identify malnutrition. And measuring the albumin per se is not a very good tool to do that. But if somebody has a poor wound healing, the most prominent problem is malnutrition. So, treating malnutrition with poor healing is really number one.

17:00 Pamela D. Wilson: And the screening tools, what are they? Can you explain, give an example of one?

17:05 Dr. Nicolaas Deutz: Yes, there are several screening tools. You have screening tools for older adults; it’s called “MNA”. You have screening tools that are called “SNAQ.” There are many different screening tools. In our organization, we came up with some new definition of malnutrition that probably seems to work better. But for the screening, it’s actually very clear. You just have to ask your patient, “Do you have less desire to eat, or do you feel more weaker, or did you lose any weight?” That is usually enough to identify that there is most likely a problem. And in that case, you actually already can have a better look at the diet. In general, older adults that are more inactive or have any chronic disease have a very high chance to have malnutrition. So, it is always good for every older adult to look at their intake. And again, calories are not so important for older adults. It’s really more the protein intake to look at.

18:10 Pamela D. Wilson: And so, really just something important. If a caregiver is bringing an older person to a doctor’s appointment, maybe the caregiver should be the one to say, “Doctor, can you take a look at nutrition and let us know if we have a problem here?”

18:23 Dr. Nicolaas Deutz: Yes, but the chances are there that a physician doesn’t know what to do with it and then probably refers that person to a dietician.

18:31 Pamela D. Wilson: Okay, so a dietitian would be the next step then?

18:35 Dr. Nicolaas Deutz: I think so, yes, I think so.

18:37 Pamela D. Wilson: Okay, perfect. We are going to continue our conversation with Dr. Nicolaas Deutz about nutrition after this break. Follow The Caring Generation on your favorite podcast sites. Podcast replays and transcripts of the show are on my website, www.PamelaDWilson.com.

18:51 Pamela D. Wilson: I’m Pamela D. Wilson, your host. You’re listening live on the BBM Global Network, Channel 100, and TuneIn Radio. Stay with us. We’ll be right back after this break.

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21:02 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert. I’m your host. You’re listening to The Caring Generation radio program for caregivers and aging adults, coming to you live from the BBM Global Network, Channel 100, and TuneIn Radio. Let’s continue our conversation about nutrition with Dr. Nicolaas Deutz, Director of the Center for Translational Research in Aging and Longevity at Texas A&M. Dr. Deutz, I found a statistic saying that 47% of older adults are malnutrition. But like we talked, it’s not identified until they go to the hospital. Is there a certain age where we want to start looking at our nutrition issues, so we don’t become that statistic?

21:42 Dr. Nicolaas Deutz: Yes – No, I think that in every older adult, this is absolutely a risk. Some people indicated malnutrition 10% at home all the way up to 80% in nursing homes. So, in older adults, it’s absolutely something to look for. It is, by the way, also malnutrition in children is possible because of disease. So, it’s not only a disease of old adults. You will find it everywhere. But the point about malnutrition in the hospital is that malnutrition is very dangerous in the hospital. Because people can die at a higher rate when they are malnourished in the hospital and, for instance, they get a surgery or any other therapy. So, I believe, and many with me believe that every patient that enters the hospital deserves a discussion that if they have to go to the hospital for an elective procedure, they should have a malnutrition screening to be absolutely sure that there is no issue.

22:39 Pamela D. Wilson: That is a great idea. I’ve never thought about that. I’ve also had some older clients who, the physicians diagnosed them with failure to thrive, and I think nutrition is a part of that. How, besides the whey protein, are there other things that caregivers can do to supplement meals to improve this?

23:00 Dr. Nicolaas Deutz: First of all, failure to thrive usually is related with a chronic disease. Because a chronic disease makes it just hard for the body to stay in a good health. And so, one of the things, of course, is first look at whether there is malnutrition. If you can deal with the malnutrition easily, then the next step is usually to increase activity and do exercise protocols. And it looks very, very simple to look at it. But those two interventions, having a sufficient amount of protein and doing exercise protocols and increased activity, are really very effective. There have been many studies to show that these interventions can be more effective than many medical treatments. So, this is the mainstream of keeping people in a healthy condition. Failure to thrive means that just those two things are not there.

23:56 Pamela D. Wilson:  And you mentioned chronic disease being a part of this. In your research, are there some diseases that cause, that are more likely to cause malnutrition than others, or is it just across the board?

24:07 Dr. Nicolaas Deutz: So, we do research in people with chronic heart failure, with COPD, with all kinds of inflammations, acute or chronic, and any disease in the older, including severe diabetes. All have a much, much higher chance of becoming malnourished, so and chronic diseases are very prevalent in older adults, as we know.

24:32 Pamela D. Wilson:  So really, anybody diagnosed with one of those conditions, they should take more or pay more attention right away to nutrition than waiting for something to happen, it sounds like.

24:41 Dr. Nicolaas Deutz: Absolutely, absolutely. Because it’s much easier to prevent than to treat afterward.

24:47 Pamela D. Wilson:  So like you said, a lot of older people because they’re not active, they don’t eat, and then they say, “Well, I’m not hungry.” So how do we convince them? Sure, you can put whey protein in food. I don’t know if an older person will do that. How do we convince elderly people that this is important to pay attention to?

25:04 Dr. Nicolaas Deutz: Yes. I think this is the key question because if you do not like to eat anymore because you’re not hungry, it’s very, very hard to keep eating again. The only thing left in our profession is actually thinking about the quality of the protein. So sometimes people take the protein in the form of vegetable protein or lower quality proteins. And by just changing the type of protein that somebody takes, you can increase the amount of essential amino acids in the meal, and that would be helpful already. So that’s why we always advise people to go for yogurts and those type of products because they contain very high-quality protein. It’s better to take a yogurt than to eat an apple because the yogurt contains way more protein than the apple.

25:54 Pamela D. Wilson:   Oh, that’s good. So, if somebody likes yogurt and they like ice cream. You can mix that up and throw some whey protein in, and that would be okay? [laughter]

26:02 Dr. Nicolaas Deutz: Oh, great. Yes, yes. It looks really strange. But when you are born, you drink milk for half a year and nothing else. And you can grow unbelievably fast on that. When you are old, you should do exactly the same because you stay in good health. It’s exactly the same mechanism. There’s no difference here.

26:21 Pamela D. Wilson: That makes sense. So, what about people, though, who have sensitive stomachs? Maybe they can’t drink milk, or soy, or whey protein. What then do they do?

26:29 Dr. Nicolaas Deutz: Yes. First of all, soy protein is not a good protein, it’s a low-quality protein, so I would not advise that. If anything, you should really advise dairy proteins, but if they have upset stomach, that’s a hard thing, because it has to go through the stomach before it’s in your bowels to be digested. So it’s really a matter of finding what people like. If people like ice cream, then they should take ice cream and create an ice cream that has all the nutrients. If the people like a soup, then go for the soup. So, people should really go for the meals that they really enjoy, and that does not give them stomach problems. But this is really an individual thing. You have to have somebody that really goes through all the things to find that food that is adjustable and people like that, and have not those stomach problems, and then try to fortify those meals.

27:27 Pamela D. Wilson:  And so, like you say, a nutritionist could help somebody who maybe says, “Well, I can’t drink milk, but what else can I do?” They would have the expertise to help?

27:35 Dr. Nicolaas Deutz: Yes, so those things a nutritionist probably can help because they understand that milk has some lactose and people have problem with that. Yogurts do not have lactose, so that is absolutely more preferable. Some people like maybe more cheese, which is also an excellent source. All these things are there. So, that’s kind of the advice. But I have to be honest that information is everywhere. You can go through the internet, and you will find that information everywhere.

28:00 Pamela D. Wilson: Wonderful. So what about peanut butter? I just thought of that. Is that a good source of protein or too much fat?

28:07 Dr. Nicolaas Deutz: Now, first of all, it’s a vegetable protein, so the quality is low, and there is, of course, a lot of calories, and some people still think that you can grow muscle with calories, really that’s not true. You grow muscle with protein. So, you have to go to the highest quality protein. It’s even better to have not just barely enough calories but enough proteins. But it’s much better than if you have too much calories and not enough protein because that doesn’t work.

28:35 Pamela D. Wilson: Okay, Dr. Deutz, I thank you so much for joining us. This has been a great interview. I’m sure it’s going to be helpful for our listeners. Listeners, you can follow The Caring Generation on your favorite podcast sites. The podcast replay of this show and the transcript will be up next week. Every Caring Generation Show is there at my website on www.PamelaDWilson.com. I’m Pamela D. Wilson, your host. You’re listening live on the BBM Global Network, Channel 100, and TuneIn radio. Stay with us. We’ll be right back.

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31:04 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert. I’m your host. You’re listening to the Caring Generation radio program for caregivers, and aging adults, coming to you live from the BBM Global Network Channel 100 and TuneIn radio. The Caring Generation is the place for tips about health, well-being, and caring for aging loved ones. Please share the Caring Generation with your friends, family, co-workers, the companies you work for, your social groups, churches, and everywhere. One in four people you know are caregivers looking for hope, help, and support that is here on the Caring Generation.

Let’s talk more about care forward-thinking combined with warning signs for helping elderly parents so that we can replace caregiving fears with confidence. I’m regularly in contact with caregivers who feel overwhelmed by trying to help elderly parents stay at home. The healthcare system can be unhelpful, it can seem to prevent care, maybe cause more difficulties, and in these situations, it may feel a little difficult to be confident about overcoming obstacles. Elderly parents can feel maybe that it’s too much trouble to change habits or behaviors, and this is when it is especially important to talk about the costs and the consequences of having to leave home and move to a care community. Because if we don’t explain what can happen, many times, elderly parents don’t see that, and sometimes they won’t want to participate in care.

32:30 Pamela D. Wilson: While we don’t have to accept the idea that getting old means being sick, what I can tell you is that adults with positive attitudes about aging, they live active lifestyles and they really fight and work every day to remain self-sufficient. We can all build resilience to overcome health concerns, to avoid negative thinking, and to be proactive in all aspects of our life, especially our health. I always recommend that instead of waiting for a crisis, and then reacting to the crisis, be proactive. Start today, looking at these issues for your elderly parents. Look for warning signs of helping elderly parents and change your thinking from, “Well, this is just the way it is,” to creating solutions. Work toward better health and the ability to perform activities of daily living to help elderly parents stay at home.

33:21 Pamela D. Wilson: Embrace care forward-thinking to manage health issues and risks to avoid falls in the home, so that your parents don’t have to go to a care community or a nursing home. Ask these questions. Why not install bathroom safety equipment, like a raised toilet seat, grab bars, a shower seat, and a handheld shower wand? Why not walk every day? Work on strength training and complete balance exercises to avoid falls. These are the positive thinking ideas of care forward-thinking that supports self-reliance and hope. I think we all want to stay at home when we’re older, but we have to learn how to make this happen. When you notice warning signs for helping elderly parents, learn yourself from that experience. Look at the same concerns for yourself. Studies confirm that symptoms of Alzheimer’s and Dementia begin as early as 20 years before a diagnosis. This means that we are never too young or too old to pay more attention to our health.

34:18 Pamela D. Wilson: Care forward-thinking emphasizes equal participation of caregivers and elderly parents to support independence and the ability of your elderly parents to do the things that they need to, to stay home. Care forward-thinking also takes honest discussions about thinking positively and about problem-solving to close these gaps. Gaps might exist in the ability of elderly parents to complete activities of daily living. Is mom or dad consistent in their ability to bathe or shower safely? Are they afraid of falling? Can your elderly parents complete all of their daily hygiene tasks? Dress? Bend to put on shoes? Can they walk a couple of blocks without getting tired or out of breath? Easily stand from a chair? Get out of bed? Walk a flight of steps? What about you? Can you do all those things? As parents age, like Dr. Deutz mentioned, these physical tasks become difficult and challenging, because the body becomes physically weak. We don’t have enough protein. When we age, physical activity can also make our muscles sore. That is usually a sign that muscles are weak or that there’s some type of physical health issue happening. One solution to avoid injury is to talk to your doctor about a physical therapy order. These are exercises to strengthen and balance weak muscles. You can do those exercises with an elderly parent, or find a way to motivate your parents to do the exercises themselves.

35:44 Pamela D. Wilson: You won’t see results overnight, but maybe in about four to six weeks, you and your elderly parent should notice an improvement. There are also simple exercises that can be done with those rubber exercise bands. They can be done sitting, standing, lying in bed. After looking at physical strength as a significant warning sign for helping elderly parents, weigh your parents. Again, Dr. Deutz mentioned any change in weight; any change in health can result in a change in weight. For frail, elderly parents, that change usually results in a weight loss instead of weight gain. When I had clients, I was adamant about taking the weight of my clients two to three times a week, to make sure there were no changes. If your elderly parent is in a frail state and needs a lot of care, any change in weight can be significant. Keep talking about their desire to stay at home, the daily actions that they want to take to make this a reality, so that they participate. Changes in memory loss can also result in losing weight and physical strength. Elderly parents with memory loss, they forget to eat. Forget to take their medications. When you visit your parents’ house, think about creating a checklist for caring for aging parents. That list can help you identify these warning signs for your elderly parents.

37:00 Pamela D. Wilson: Let’s say that one concern is walking downstairs to do the laundry. Instead of having you take over the laundry, which you could easily do, what steps can you take to make doing the laundry safe for your elderly parent? A double stair railing is one solution. If there are vision problems, you can put safety strips on the edges of the steps. As long as there is no reason for your parent not to walk steps, doing laundry can be a positive source of physical activity and exercise. It’s these little things, like coming up with solutions to remove safety risks so that a parent can continue to do laundry, that supports a care forward-thinking attitude. Care forward-thinking means training your minds to be proactive and positive, and solve problems. Other warning signs for helping elderly parents include not taking medications correctly. This might be another area where you can help. The tricky part is creating a checklist for caring for elderly parents, but not to make your elderly parent feel like their life is under a microscope. We don’t want elderly parents to become defensive. We want them to stay involved, be positive, be proactive about their health and care.

38:06 Pamela D. Wilson: After this break, we’ll talk more about activities of daily living, care forward-thinking, and I’ll share some tips to gain confidence in caregiving situations, whether you are the elderly parent or whether you are the caregiver. You can follow, like, and take The Caring Generation with you wherever you go on Apple Podcasts, Google Podcasts, Pandora, iHeart Radio, Spotify, Spreaker, Stitcher, SoundCloud, Castbox and more. Helpful information for caregivers and aging adults is also on my website at www.PamelaDWilson.com. This is Pamela D. Wilson, caregiving expert. I’m your host. You’re listening to The Caring Generation, live from the BBM Global Network Channel 100 and TuneIn Radio. Stay with me. We’ll be right back.

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40:57 Pamela D. Wilson:  This is Pamela D. Wilson, caregiving expert. This is The Caring Generation coming to you live from the BBM Global Network, Channel 100, and TuneIn radio. Follow me on social media. On Facebook, watch my videos. Follow me and share my posts. My page is PamelaDWilson.page. On Twitter, I am @caregivingspeak. On Instagram, I am @wilsonpamelad. And on LinkedIn, I am Pamela D. Wilson, caregiver expert.

41:24 Pamela D. Wilson: Do you have a sense of how the abilities of your elderly parents have changed in the past six or 12 months? Are there physical activities your parents are no longer doing? If yes, the activities that they are no longer doing are part of the warning signs for helping elderly parents who want to stay at home. It’s up to you to identify the change. Talk to your parents about what they’re doing less of, and find out if they’re more tired, and then problem-solve why the change occurred, and come up with solutions. The benefit of identifying issues and problem-solving is preventing greater health issues and greater risks. The downside is that it can take time and effort to work on these issues. This is where having that checklist for caring for aging parents is positive so that you could also talk to your brothers and sisters and other family members and ask for their help in noticing changes in your elderly parents.

42:20 Pamela D. Wilson: When you’ve identified these warning signs with your parents, bring up the concerns rather than waiting to delay, waiting to fall into that caregiving trap, waiting for something to happen, and then talking about it. Our minds, when we worry, can be one of the greatest limits to our success in all aspects of our life, not just caregiving. Caregivers and elderly parents benefit from a cheerleader, a friend, a role model who is honest about challenges, but positive about changes and solutions. In addition to having complicated medical conditions, problems performing activities of daily living like we talked, bathing, dressing, eating, walking, standing, and sitting, those are the most significant reasons that elderly parents cannot stay at home. It can be easy once you start to pay attention to notice physical changes in your parents and changes that result from chronic disease that can make it more difficult to be physically active.

43:21 Pamela D. Wilson: It is more difficult to notice changes in memory, though, that these are other warning signs for helping your elderly parents. The memory changes can be slight. They can actually happen over several years. And when elderly parents are diagnosed with memory loss, sometimes we’re looking for this physical sign that usually doesn’t exist. Being diagnosed with memory loss, it’s not like breaking your arm or having a fall where your arm hurts. It’s broken, you put on a cast. Memory loss isn’t a sudden event like that. And for that reason, it’s difficult to realize memory loss and its consequences. But that change in memory for a person, it’s similar to a change in thinking, too, because elderly parents don’t notice it. Sometimes they’ll say, “Well, you know, this memory loss is just kind of creeping up on me,” and they fail to do anything about it.

44:10 Pamela D. Wilson: Again, negative thinking and worry just is not good for caregiving situations. You want to be more proactive about problems, more proactive about health issues. Make sure you’re going to doctor appointments. I know it can be time-consuming. But that’s the way to be proactive to catch health issues before they become serious. And the fact is there’s rarely anybody to tell caregivers and aging adults about health or about activities that should be done to make daily life easier. The health care system and society just make aging out to be this really sad experience. They don’t provide any solutions for identifying warning signs for helping elderly parents. It’s not like there’s anybody out there throwing you a life raft or engaging in any type of uplifting activity, of course, except on this radio show. So how do we bring care forward-thinking into overwhelming care situations? I’m going to share five tips for gaining confidence in caregiving situations where warning signs for elderly parents exist. The first one is to be really thankful and appreciative of the situations that exist. Be thankful for noticing these warning signs earlier so that you can act and prevent the situation from getting worse.

45:23 Pamela D. Wilson: Taking action is that solution to fear and loss. Also, be open to suggestions and recommendations. Avoid saying, “Ah, that won’t worked,” and be around positive people. So, have you ever noticed that people who are hurting hurt other people? Have you ever noticed that people who are angry or negative, they want to pull you down into that quicksand with them so that you’re both drowning in misery? Don’t go there. It can be so difficult to resist being pulled into the scenarios and the life dramas of others. Don’t let anybody else pull you down. The number two tip that supports care forward-thinking and helping elderly parents stay at home is having confidence and courage to set boundaries. Elderly parents can pull you down if they’re not motivated to change. Have a boundary, refuse to listen to their complaints. Support positive solutions. Keep your positive thinking battery charged up. Don’t let your mind fill you with thoughts and fears of everything that can go wrong. When you start to think negative, put a positive thought in there. When you feel exhausted and distracted, create a caregiving survival skillset that you immediately put into action to stop those negative thoughts and worries.

46:34 Pamela D. Wilson: Do what you can do to break that pattern, to change to positive thoughts and activities. Bounce back. Be resilient. Don’t give anyone else control over your mental attitude and your thoughts. It does take work and practice, but you can do it. Once you start to think something negative, toss it out of your mind and think something positive. Tip number three to gaining confidence in caregiving situation is to identify and rid yourself of those fears. Chop those fears up into pieces that you can work through to build your confidence. If one of your fears is having a conversation with an elderly parent about their lack of participation and care, write out that conversation. Type it up on a piece of paper. Write out what you think your parents will say and develop several positive responses. Turn every single obstacle your parent raises into an opportunity. The less you allow negative thinking and worry to set off your emotions, the more peaceful and less stressful your life will become. Our choices create our life. Choose solutions instead of fear. Tip number four is realizing that life is filled with unexpected situations. We become more confident by working through adverse situations. We gain courage by being resourceful, and then we look back and see what a good job we did and congratulate ourselves.

47:50 Pamela D. Wilson: Overcome obstacles one day at a time. Take life and surviving one day at a time. That gives us the confidence to identify warning signs for helping elderly parents and solve the issues with less worry and less fear. It also helps us manage things that we are worried about for ourselves. Tip number five to end worry about warning signs for helping elderly parents is to step out of your comfort zone, to show up every day. Don’t compare yourself to others. Be yourself. Keep moving forward with your plan, and don’t allow, again, the bias of others, their negative attitudes, their negative thoughts to affect you. Tune out all of that noise and that drama from other people. Be with people who raise you up. Be with people who have positive attitudes that will help you tune in to that confident, competent, and self-resourceful person that you are because you are.

48:43 Pamela D. Wilson: Helpful information for caregivers and aging adults are on my website at www.PamelaDWilson.com. Also, check out my Caregiving TV Channel on YouTube where you will find hundreds of videos. I’m Pamela D. Wilson, your host. You are listening to the Caring Generation live from the BBM Global Network, Channel 100, and TuneIn Radio. Stay with me. We’ll be right back after this break.

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51:16 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert. I’m your host. This is The Caring Generation Radio program for caregivers, and aging adults live on the BBM Global network channel 100 and TuneIn radio. We’re back talking about care forward-thinking and more tips to eliminate fear and gain confidence in caregiving situations. Our minds are the greatest weapons we have against fears of caring for elderly parents, fears about aging, illness. Believe it or not, we are all going to be the age of our elderly parents someday, and our children, if we have them, will be in the place that we are in today, maybe fearful of having to care for us.

52:00 Pamela D. Wilson: Our mind is that weapon that we have. We want to think positive. We want to be around positive people. A lot of caregivers share feelings with me of being overwhelmed of situations where they feel hopeless or don’t see a way out of a difficult situation. I understand we’ve all been there. On The Caring Generation, if you go back and look at the podcasts, there probably are over 24, they are on helpful topics, heart disease, managing diabetes, how to manage your mood, how to help parents who refuse care. A lot of helpful information is here.

52:33 Pamela D. Wilson: If we’re honest, there are days when we all need encouragement just to keep going. Sometimes, it is reading an inspirational article on the internet, listening to a podcast. Other times, it might be a single stranger showing us an act of kindness. Make the decision to be positive every day and to keep taking small steps and creating positive habits that will show progress, maybe not immediately, but in time. On any day, anybody is always fighting a battle to survive. We have to think about that. Encourage your elderly parents to notice and pay attention to warning signs of changes in health. Encourage your elderly parents to do everything possible to participate in activities of daily living so that they can remain independent and stay at home. The more independent they are, the less dependent they will be on you.

53:32 Pamela D. Wilson: And for elderly parents, it can feel like a struggle to remain at home when they’ve allowed life to go so far in that other direction that they are physically weak. That they have poor nutrition, that they have a list of health conditions that they’re fighting. When we get tired of fighting, we need a person, an angel, to come into our lives to lift us and give us hope. Angels exist, don’t lose faith. Solutions exist for warning signs for helping elderly parents. Activities of daily living that have become a struggle can be improved by taking actions and sending fear away and thoughts of, “I can’t do this.” Elderly parents can stay at home if they participate. I want to share three quotes that I found about strength, courage, confidence, and fear. The first is by Eleanor Roosevelt: “You gain strength, courage, and confidence by every experience in which you stop to look fear in the face. You are able to say to yourself, “I have lived through this horror. I can take the next thing that comes along. You must do the thing you think you cannot do.”

54:39 Pamela D. Wilson: The second quote is by Henry Ford: “One of the greatest discoveries a man makes, one of his greatest surprises, is to find he can do what he was afraid he couldn’t do.” And the last is by Napoleon Hill: “Fears are nothing more than a state of mind.” Next week, we’ll throw more caregiving fears out the window when continuing with the idea of care forward-thinking. I’ll be talking about how to keep your job and care for elderly parents. We’ll also talk about eliminating another caregiving fear: How to avoid caregiver discrimination in the workplace. If you don’t have caregiving programs at your company, it’s time to tell your human resource manager about The Caring Generation podcast and my website www.PamelaDWilson.com.

55:26 Pamela D. Wilson: Thank you for being proactive and interested in health and well-being. Share The Caring Generation with your family and everyone so that we can make caregiving something we talk about. Podcasts of all the shows are on my website at www.PamelaDWilson.com. Thank you so much for joining me on The Caring Generation radio program for caregivers and aging adults, coming to you live from the BBM Global Network Channel 100 and TuneIn Radio. Have a fabulous day tomorrow and a great week until we are together again.

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56:00 Announcer: Tune in each week for The Caring Generation with host, Pamela D. Wilson. Come join the conversation and see how Pamela can provide solutions and peace of mind for everyone here on Pamela D. Wilson’s The Caring Generation.

Looking For More Help Managing Care for Yourself or Elderly Parents? You’ll Find What You Are Looking For in my Caring for Aging Parents Blog.

About Pamela Wilson

PAMELA D. WILSON, MS, BS/BA, NCG, CSA helps caregivers and aging adults solve caregiving problems and manage caregiving needs through online programs, live support groups, and an extensive caregiving library that includes articles, podcasts, videos, and webinars.

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