Alzheimer's Care

Monday, 4 August 2014

Sandwich Generation Stress: 6 Ways to Cope While Raising Kids and Caring for Elderly Parents

by Paula Banks, LSW, CMC 

“My boss yelled at me for missing my third day of work in two weeks, but I had to go help Dad. What choice did I have? His dementia is getting worse and he keeps forgetting to take his medication. Last night the neighbors found him wandering around in his pajamas. Two hours after I checked on him, my teen's assistant principal called to tell me my daughter is being suspended for skipping school again. On top of all that, my husband is traveling a lot for work, the house is a mess, no one is paying attention to the dog, I've put on 25 pounds and I can honestly say that I haven’t had one day of fun in the past three years. I feel like I’m going to disintegrate if something doesn't give soon.”

In families where there are tremendous competing needs (like kids and aging parents) these crises can become a self-perpetuating situation.

If the above scenario sounds familiar, welcome to the “Sandwich Generation.” There’s almost nothing more draining, stressful, emotional and guilt-inducing than caring for an elderly parent or relative while raising kids. I know what this is like because I’ve been there myself—and my life’s work has been devoted to helping people who are caring for elderly or sick relatives. If you are in this situation right now, you’re probably feeling pretty overwhelmed and alone. I want to tell you that regaining some peace and order in your life is possible. You can learn how to handle the obstacles and difficulties that arise—and you can also let go of some of the guilt, stress and other energy-draining emotions that pull you down and make you feel defeated and exhausted.

Related: How to stay sane while caring for your parents and raising your kids 

I understand how alone, frightened and unsure you can feel—and how cheated, as well. Maybe this is that time in your life when you thought all your hard work raising a family and advancing your career would have paid off. Instead, your life feels out of control, your family is a mess, your marriage is on the rocks and you are very close to losing your job. Well, let me tell you, you are not alone! There are approximately 20 million women in this country between the ages of 45 and 56—and a whopping 10 percent of them are members of the Sandwich Generation. The numbers of hours and dollars they spend in the care and support of their children and parents are into the billions. (While we have many more men than ever before stuck in the Sandwich Generation, the burden still falls to women in most cases.)
It’s no surprise how this has evolved over the past 20 years, given the demographic changes in this country. We have more women in the workforce, increased life expectancy, couples having children later in life and smaller families—meaning fewer siblings are available to share in the caregiving for their elders. And for parents stuck in the Sandwich Generation, the stress can be extreme. It’s no wonder that marriage and family therapists often refer their clients to geriatric care managers for support.

Related: Kids acting out while you try to take care of your elderly parents? 

My Mother Fell Down Again—and My Kids Are Constantly Acting Out. Help! 

Children often act out when their parents are under extreme pressure from the numerous responsibilities of taking care of elderly or sick relatives. Acting-out behavior might occur if your child is:
Anxious about what's going on within the family
Sad about the changes their grandparents/relatives are experiencing
Feeling ignored because your attention is elsewhere
Scared of what's going to happen

Your child might also just be plain angry and feeding off the stress in your household—a house that might feel as if it’s frequently in crisis mode. If this is the case, it’s important for you to step back, take a deep breath, evaluate what's going on in your home and make a plan to take back control of your situation. Preparing by creating a plan will help make you feel stronger and more empowered in your life—and less like you're living from crisis to crisis.

What does this plan look like?

1. Stop the “Screech”…and Breathe. When it comes to crises, I ask my clients all the time, “Is someone in immediate or imminent danger of death or injury? If the answer is “no” then I tell them it is not a crisis. It may be a major issue or major concern but not a crisis. What happens in families where there are tremendous competing needs (like kids and aging parents) is that these crises just become a self-perpetuating situation. Everyone is meeting “screech with screech” and there is simply no need for it. I advise my clients to take four very deep breaths, clear their head and slow down that “fight or flight” response. Take a step back and then begin. They can teach their kids to do this also by simply refusing to go to screech.

Your parent's crisis might have come before your child's or vice versa. One may be feeding the other. If you step back, take a look and stop reacting all over the place you can break it down to understandable, manageable pieces. I can’t say it enough: Breathe. It sounds silly, but studies show that people who are under tremendous stress often forget to breathe. Steady, mindful breathing calms us down and gets crucial oxygen to our brains. That clarity will help you make better decisions.

Related: How to maintain your sanity while you care for your parents and raise your kids.

2. No More “Shoulda, Coulda, Wouldas” I always say that guilt is one of the most useless emotions—and the most embraced one in the world! We humans are great at feeling guilty for everything. It takes a lot of work to let go of guilt, especially for those of us in the Sandwich Generation. Because you are caring for kids, your aging parents, your spouse, your home, your community and your job, you probably feel like you have a million masters and can never please any of them. I believe this is where we must understand and tell ourselves daily that anything and everything we are doing is helping and that it matters. Identify where you might need some support or assistance, but don't get stuck in the constant “coulda-shoulda-woulda's” because it is just counter-productive.

3. Ask for Help…And Say “Yes” to It When someone offers to help, say, “Yes!” And sometimes you will need to ask for help as well—don’t hesitate. My clients are always amazed at how many people will pitch in if you ask. If you’re raising kids and caring for an elderly or sick relative, it’s also important for you to know that there is help for you—both for dealing with your children and your aging parents. The key is to know how to access that assistance.

For some, that assistance is as close as your child's school. School social workers and guidance counselors can be a good resource for finding assistance and services for your child and family. Often, people around you are dealing with aging relatives as well. Try reaching out—what’s the worst that could happen? And don't forget your faith community. Talk to your clergyman and ask him or her to send word out that you need some help with chores, respite, sitting with your elder or meals. People love to help and will do so if asked. The Area Agencies on Aging (in almost all communities) can help with resources as well. Go to to find one in your area.

4. Include your child in the family plan. I am a big fan of intergenerational learning—and there is nowhere better to start than your own family. No matter their age, ability, maturity or behavior, all children can help their parents care for their elderly relatives. Whether it’s your five-year-old son bringing Nana a cup of juice, your teen visiting with Grandpa and helping him walk out to the sun porch, or your 23-year-old driving Aunt Rose to her doctor's appointments, all kids can help in some way. Helping others makes us feel needed and wanted—and that we matter.

I think it’s also important to share with your kids about the changes that are happening within the family and with your aging parent. When kept “age appropriate,” the information will actually decrease your child's fear, anxiety and acting-out behaviors. For example, if you have a grandparent who has suffered a hip fracture and is going to be staying with you for a while until they heal, you might tell a 4-year-old, “Nana has a boo-boo on her leg. We are going to help her feel better." You can give your 14-year-old more information:  “Nana fell in the driveway and broke her hip. She's in a lot of pain and needs our help right now. She’s going to be staying with us for a while until she feels better. We really need you to sit with Nana after school and help her out until we get home from work." Keep it age appropriate but do share—it’s important for kids to feel needed and respected.

Related: Doing too much for your kids—and everybody else?

There is very little we should not involve our kids in when caring for aging parents. Your kids always know more than you think they do! And if they are too young to understand it, they still know something is happening and changing. Even death, one of the scariest words in the world for us humans, is something kids can be part of. Because it is part of the circle of life, kids should know that it happens, is part of the life cycle and not a silent subject.

While it is important to keep things age appropriate when it comes to any issue of aging, there are teachable moments everywhere. So, for instance, while it is unpleasant for a child to see a grandparent who is agitated due to their dementia, you can learn how to decrease the agitation, have the child see the grandparent when they are most calm, and explain that their dementia causes them to act differently than they used to but they are still the same Nana who always loved them. There are many resources out there, including, where one can learn about dementia, behaviors and coping strategies.

5. The 3 R’s:  Respite, Respite and Respite. When you’re sandwiched in between all this stress, it’s crucial to take some time for yourself. Schedule “respite” into your calendar. Meet a good friend for coffee if you can, or call someone to talk. Take a book to the beach, take a walk around your block, go shopping and do something fun for you. Build this into your plan of action because by doing so, you will be healthier physically and emotionally—and prepared to keep going.

This may seem impossible because you may be thinking, “Who will watch Mom when she can’t be left alone?” The answer is easy: You can ask a friend to sit with her—or even offer to pay for their time. Also, home care agencies have people trained to care for your loved one. They can provide respite so you can get out for a while. Most have two hour minimums and cost about $25 an hour. If you can afford it, do it! It is worth every penny to help you get refreshed and keep you sane—and to give your mind and body a break from caregiver mode.

Related: How to stop living in “crisis mode” with your elderly parents.

6. Stay in touch. One of the tough things about being caught in the Sandwich Generation is that between caring for your kids, trying to keep your job and caring for aging parents, you have little to no energy left for socialization with peers. Socialization is critical to all of us for emotional and physical health—so reach out. Talk to family and friends, your faith community and try to reconnect with the groups or clubs that used to interest you. These are critical connections that will sustain you. Don't let them drift away. Feeling isolated and alone is one of the worst parts of caring for others, and is also one of the hardest aspects of elder care. If you simply don't have time or energy for these things at present, make it a goal for the near future. And if you have no one to talk to, there are many caregiver support groups throughout the country. Go to to find one near you.

I always say that “action equals strength!” By creating a plan to handle the situation of being caught in the Sandwich Generation, you will be able to take control of the chaos you are swimming in. You will be able to breathe, calm your house down, look at and separate the issues of your children, aging parents, marriage and yourself. You owe it to your physical and mental health to understand what is going on and how to get the assistance needed to make a plan that will benefit everyone in your family.

Website Reference:

Monday, 14 April 2014

Exercise for the Arizona Elders

Everyone wants the benefits of exercise throughout their life. But we often wonder if it is safe for seniors to exercise. According to the American Academy of Family Physicians almost all older people can benefit from additional physical activity. With regular exercise an healthy elder can be protected from chronic disease, improves mood and can lower their chance of injury.

As the body ages, it takes a little longer to repair itself, but moderate physical activity is good for people of all ages and of all ability levels. Truth be told, the benefits of your elderly parents exercise program highly outweighs the risks. Even elderly people with chronic illnesses can exercise safely. Many medical condition such as Alzheimer's and dementia, heart disease, diabetes, colon cancer, high blood pressure and obesity can be improved with an exercise program.

In fact, elders who regularly exercise can see an improvement in their health to include improvements in blood pressure, diabetes, lipid profile, osteoarthritis, osteoporosis, and neuro-cognitive function.

A regular exercise program can improve:

Immune Function – A body can fight off infection and sickness and recover more quickly less strenously when healthy instead of stealing energy from the body.

Cardio-Respiratory and Cardiovascular Function – The risk of heart disease and high blood pressure is lowered with regular physical activities. If the elderly person has hypertension, exercise will lower blood pressure.

Bone Density/Osteoporosis – Exercise protects against loss in bone mass and will reduce the risk of osteoporosis and lowers risk of falling and broken bones because of better bone density.  Research shows that strength training can dramatically reduce the loss of bone mass, help restore bones, and contribute to better balance and less fractures.

Gastrointestinal Function – Regular exercise promotes the efficient elimination of waste and can improve digestive health.

Chronic Conditions and Cancer – Regular physical activity lowers risk of Alzheimer's disease and dementia, diabetes, obesity, heart disease, osteoporosis, colon cancer and can help in the management of high cholesterol and arthritis pain.

Regular physical activity is also associated with decreased mortality and age-related morbidity in older adults. In addition, a study by the Journal of the American Geriatrics Society examined exercise in the elderly and found that exercise training led to improvement in functional reach, balance and fear of falling.

Often, frail elderly people are unable to maintain an aerobic exercise routine on a regular basis due to lack of endurance. Age-related changes in the cardiovascular system have significant effects on cardiac performance, it has been estimated that 50% of endurance loss can be related to decreased muscle mass.

The best exercise program for the elderly consists of three components: aerobic exercise, strength training, and balance and flexibility. To learn more about how your parents can improve their health with a care manager contact Desert Care Management by visiting their website or calling at 480-804-7200.

Friday, 4 April 2014

It's Time for National Geriatric Care Manager Month!

Each May we celebrate the work of our members and promote the profession of geriatric care management. Care managers are out in their communities, sharing information, making presentations, and opening their doors, inviting the public to learn more about the profession and the benefits it brings to families across the country. Resources and tips for making your event a success may be found on the NAPGCM website here.

Now is the time to start planning your events and book your speaking engagements.

May is also Older Americans Month, and this year's theme-Safe Today. Healthy Tomorrow.-focuses on injury prevention. NCOA's Falls Free® Initiative will be leading numerous advocacy, awareness, and educational efforts to help seniors stay safe and independent. Explore the Falls Free® Initiative on the NCOA website.

We hope you'll take advantage of these resources during National Geriatric Care Manager Month! And we'd love to hear your success stories!

Visit our site for more information about Care Plans in Arizona, AZ Elderly Coaching and Care Management in Gilbert, Arizona.

Monday, 31 March 2014

Desert Care Management Event Calendar

Salibas Pharmacy Sponsors "Muhammad Ali Parkinson's Conference"
Wed, April 2, 8:00am – 4:30pm

Jackson White Law Seminar "Navigating the Journey"
Mon, April 7, 1pm – 2pm

Central Phoenix RAIN Networking Event
Tue, April 8, 8am – 9am

AZCAL HEALTH FAIR "Maneuvering thru the Healthcare System & Heart Health"
Tue, April 8, 9am – 11am

East Valley April SPOTLIGHT Event
Tue, April 8, 11:30am – 1:00pm

Synergy Home Care "Blood Drive & Prize Giveaway!" Invitation
Thu, April 10, 9am – 1pm

Scottsdale / Phoenix April SPOTLIGHT Event
Thu, April 10, 9:00am – 10:30am

The Citadel Assisted Living "Hoedown Networking Event"
Thu, April 10, 3:30pm – 5:00pm

Dana Law Firm "Health & Vendor Fair" Invitation
Sat, April 12, 9am – 1pm

"Health Care in Transition - Prospering Through Population Health Management"
Sun, April 13, 5:00pm – Tue, April 15, 12:30pm

Northwest Valley April SPOTLIGHT Event
Wed, April 16, 9:00am – 10:30am

LifeStream Complete Senior Living "Dr. Bill Thomas ~ Second Wind Tour" Invite
Thu, April 17, 1pm – 2pm

Pacifica Senior Living at Paradise Valley "Scottsdale Chapter R.A.I.N. Meeting"
Tue, April 22, 11:30am – 1:00pm

Jackson White Law "ALTCS 101 Training Class" Overview & Eligibility
Thu, April 24, 9am – 11am

Summit at Sunland Springs Free Seminar Latest Advances in Alzheimer's Research
Thu, April 24, 1:30pm – 3:00pm

A Mesa Community Event "Arbor Day on Arbor Avenue" Invitation
Fri, April 25, 10am – 2pm

For more Care Management Events, visit out online calendar.

Wednesday, 19 March 2014

Should You Be Worried About Your Parent Driving A Car?

Americans are living longer than ever before due to healthier lifestyles, greater awareness about nutrition, increased exercise, and more advanced medications. If seniors are active in the community or playing tennis today, then when do they become too old to get behind the wheel of their car?

Aging, no matter how healthy they are, slows down their physical and neurological mobility. Simple everyday tasks, once easy to perform, become more daunting. Slowly, our independence is robbed as aging gives way, leaving driving as one of the last frontiers of freedom we have. This makes it hard to tell a parent or loved one that they shouldn't drive anymore because their ability is impaired and they're a danger to themselves and others. If they don't recognize it themselves they'll not only be hurt by the accusation but insulted as well. Expect them to put up a fight.

Read this article for a few things to consider on before you make the decision.

If you have more questions about this or possibly a care manager in Arizona for your aging parents please visit our site or call us at 480-804-7200.

Thursday, 27 February 2014

What Should I Do When My Parents Won’t Shower or Change Clothes?

It’s hard for us to believe that our parents may not to care about their hygiene. But this problem is far more common than people think. There may be some underlying issues causing them to disregard their personal cleanliness and refusing to take showers and wear clean clothes.

If we have a parent who no longer takes an interest in staying clean or wearing clean clothes, it's wise to look at depression first. A checkup with a doctor is a good idea, especially if low energy is also part of it, or if they just don't care about anything at all. Depression isn't always obvious to an observer.

Lack of Control
As people age, they lose more and more control over their lives. But one thing they generally can control is dressing and showers. The more they are nagged, the more they resist. "This younger generation is trying to take over everything. Well, they aren't telling me when to shower, that's for sure. Besides, I'm just fine!"

Decreased Sense of Smell
What your nose picks up as old sweat, they don't even notice. Not on themselves. Not on their mate. Their senses are not as acute as yours, or as theirs once were.

Memory Loss 
The days can go by unnoticed when there isn’t a tons of activities as they were when they were young. If there isn't something special about Wednesday, well – it could be Tuesday or Thursday. They simply lose track of time and don't realize how long it's been since they showered.

Fear or Discomfort
The older adults get the more uncomfortable they are with taking risk. Falling in the shower or tripping on the tub can become a fear.  More serious is when a person with Alzheimer's or dementia is in the bathroom and doesn't understand why there is water running on them, or believes the drain that may suck them down. They just don't understand what is going on.

Look for the signs from your aging parents and be aware of their habits. If you feel it may be time for a caregiver please contact Desert Care Management at 480-804-7200. Proactive care planning for someone you care about can help prevent emergencies and accidents, thus allowing your loved one to remain safe and independent for as long as possible. Visit our website for more information.